Incidence and management of obstructed labour in eastern Nigeria

Over a five year period (1985-1989) 527 cases of obstructed labour were recorded while 11,299 deliveries were conducted giving an incidence of 4.7%. The majority of the patients (59%) were primigravidae. The incidence of obstructed labour was much higher for the unbooked patients (33%) than for the booked patients (1.7%). Cephalopelvic disproportion was the greatest cause of obstructed labour (67%), while Caesarean section was the main method of delivery (85%). The leading complications of obstructed labour were puerperal sepsis (57%), post partum haemorrhage (15%), uterine rupture (14%), and genital tract laceration (14%). A maternal mortality rate of 32 per 1000 and a perinatal mortality rate of 294 per 1000 were recorded. Education of primary health providers and traditional birth attendants on the dangers of obstructed labour and the need for early referral is suggested to reduce the incidence of this condition. Governmental assistance is also required to improve existing health facilities so that antenatal and delivery services will be affordable to all pregnant women in the society.