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Related Experiment Videos

Obstructed labor: using better technologies to reduce mortality.

G J Hofmeyr1

  • 1East London Hospital Complex, Effective Care Research Unit, University of Witwatersrand, South Africa. Gjh@global.co.za

International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics
|May 19, 2004
PubMed
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Access to essential technologies, like safe caesarean section, can significantly reduce maternal deaths from obstructed labor, especially in resource-limited settings. Evidence reviews identify both useful and unhelpful interventions.

Area of Science:

  • Obstetrics and Gynecology
  • Global Health
  • Medical Technology Assessment

Background:

  • Obstructed labor is a significant contributor to maternal mortality, particularly in low-resource countries.
  • Identifying effective and ineffective interventions is crucial for improving maternal outcomes.

Purpose of the Study:

  • To identify underutilized and promising technologies for reducing maternal mortality from obstructed labor.
  • To evaluate the evidence base for various interventions related to obstructed labor.

Main Methods:

  • Systematic review of evidence, including randomized trials and non-randomized studies.
  • Data categorized by the level of evidence supporting each technology.

Main Results:

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  • Proven technologies include contraception, external cephalic version, partogram, labor augmentation, selective amniotomy/episiotomy, vacuum extraction, caesarean section, symphysiotomy, and destructive procedures.
  • Technologies with uncertain usefulness include maternal height/shoe size, vaginal cleansing, upright posture, and vaginal lubrication.
  • Unuseful technologies identified are pelvimetry, fetal weight estimation, early labor induction, routine amniotomy/augmentation/episiotomy, and starvation during labor.

    • Conclusions:

    • Well-established technologies, especially safe caesarean section, are vital for reducing maternal mortality in resource-poor settings.
    • Evidence-based selection of interventions can improve care for obstructed labor.