Maternal and fetal outcomes of women referred to Charlotte Maxeke Johannesburg Academic Hospital with prolonged labour
Date
2018
Authors
Ashnaf, Darin Ali Othman
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Abstract
Introduction Prolonged labour or labour dystocia is a common obstetric complication and constitutes the most frequent indication for instrumental and caesarean delivery. Approximately eight percent of all women giving birth are affected by prolonged labour.1 The correct diagnosis of labour is an important part of preventing prolonged labour. It is important to have an objective diagnosis of labour in order to avoid over diagnosing labour which can result in inappropriate interventions and increase the risk of maternal and fetal adverse outcomes.
Methods This was retrospective descriptive study of women referred to Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) due to prolonged labour over a four month period from August 2016 to November 2016. The total study sample included 165 women. All 165 medical records were available for review. Forty seven babies were admitted to the paediatric observation unit, files were found for 45 babies, records were not available for two babies.
Results Women were referred for prolonged active and latent phase of labour in 77 (46.6%) and 75 (45.5%) women respectively. Only 13 women were referred due to prolonged second stage of labour (7.9%). Ninety one (55.2%) women with prolonged labour had normal vaginal delivery and eight (4.8%) had instrumental delivery. The remainder of the women (n=66, 40%) delivered by caesarean section (CS). The only maternal adverse outcome found was postpartum haemorrhage in 4.3 % (n=7) of the total study population. Out of 165 births, there was one fresh still birth. A total of 47 babies (28.6%) required observation in the neonatal transitional care unit (TICU) mainly due to respiratory distress. Nine babies (5.5%) out of 164, required admission to neonatal ICU (NICU). The institutional protocol for management of labour was followed in only 33.3% of the women. In the rest of the population, appropriate management was either delayed or not done.
Conclusion In this study, there were few maternal and fetal adverse outcomes with prolonged labour. The institution protocol at CMJAH for management of labour dystocia was followed in only 33.3% of the study population
Description
A research report submitted in partial fulfilment of the requirements for the degree of Master of Medicine in Obstetrics and Gynaecology to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, 2018