Emerging Predictors of Obstructed Labour in a Single Nigerian Centre Population of a Low Resource Setting

Abstract

Background and objective: Despite the stigma attached to obstructed labour in Nigeria, it has remained largely uninvestigated. Study determined the prevalence, emerging predictors, management modalities and complications of obstructed labour, compare them with cases without obstructed labour who delivered within the same period.

Materials and methods: A retrospective study and case-controlled analysis of obstructed labour managed at Nnamdi Azikiwe University Teaching Hospital, Nnewi, South-East, Nigeria were undertaken. One control per case was randomly selected from the remaining births by selecting the non-obstructed labour cases. Bivariate analysis was performed by the Chi-squared test and conditional logistic regression analysis was used to determine variables associated with obstructed labour. Statistical significance was accepted when the p<0.05.

Results: Of all the 5,301 deliveries during the study period, 80 cases of obstructed labour were recorded, giving a prevalence of 1.5%. Only 73 case files were available with complete information for the study's further analysis. A conditional logistic regression analysis, the risk factors were teenage pregnancy (p<0.001, Adjusted Odds Ratio (AOR):5.43, 95% Confidence Interval (CI):1.20-8.05), unbooked status (p<0.001, AOR:0.01, 95%CI:0.00-0.02), nulliparity (p<0.001, AOR:4.15, 95%CI:2.42-7.25), short stature (p<0.001, AOR:44.74, 95%CI:19.51-113.53) and birth weight (p<0.001, AOR:4.52, 95%CI:2.69-7.71). The case fatality rate was 5.5% and the perinatal mortality rate was 21.9%.

Conclusion: Majority obstructed labour have high maternal morbidity and perinatal mortality.

Keywords: Duration of labour; low income; nulliparity; predictors; teenage pregnancy; unbooked; uterine rupture.