A 5-Year review of obstructed labour at the Federal Medical Centre, Yenagoa, Bayelsa State

Abstract
Background: Obstructed labour remains a common obstetric complication with resultant fetomaternal morbidity and mortality in low-income countries. In developing countries, fistulae usually result from prolonged obstructed labour and follow pressure necrosis caused by impaction of the presenting part during difficult labour. In the infant, neglected obstructed labour may cause asphyxia, leading to stillbirth, brain damage, or neonatal death. The study aims to determine the prevalence, sociodemographic characteristics, causes, complications, and the fetomaternal outcome of pregnancies complicated by obstructed labour.

Methods: It was a retrospective study carried out on managed cases of obstructed labour in Federal Medical Centre, Yenagoa, Bayelsa State, between 1st January 2018 and 31st December 2022.

Results: A total of 46 cases were recorded out of 3,718 deliveries during the study period, giving an institutional prevalence rate of 1.2%. The main causes were cephalopelvic disproportion (76.1%) followed by malpresentation (23.9%). Obstructed labour was more common among women aged 30–34 years (39.1%). Most of the women were married (86.9%) with secondary education (47.8%) Most of the women were nulliparous (47.8%), unbooked (95.7%), and referred by traditional birth attendants (52.2%). The common foetal complications were intrauterine foetal death (23.8%) and foetal distress (11.9%), while the common maternal complications were wound infection (7.5%), uterine rupture (4.5%), and puerperal sepsis (4.5%).

Conclusion: The prevalence of obstructed labour in this study is low. The major causes were cephalopelvic disproportion and abnormal lie/presentation.

Keywords: Obstructed labour, Perinatal morbidity, Perinatal mortality, Maternal
morbidity, Maternal mortality.