Adverse maternal-fetal outcomes among mothers with obstructed labor delivered at a tertiary care hospital in Central Uganda: A descriptive retrospective cross-sectional study.

Abstract

Background: 

Obstructed labor is the single most common cause of adverse maternal and fetal outcomes, including urinary bladder trauma, ruptured uterus, sepsis, post-partum hemorrhage (PPH), birth asphyxia, septicemia, and stillbirth, among others. This study aimed to determine the frequency and types of adverse maternal and fetal outcomes associated with obstructed labor at Kayunga Regional Referral Hospital, a tertiary care hospital located in Central Uganda.

 Methods: 

A descriptive retrospective cross-sectional study was conducted at Kayunga Regional Referral Hospital in Uganda that involved a review of 2,176 hospital records of mothers who delivered from 1st January to 31st December 2023. A pretested data extraction tool was used for data collection from the patient charts. Variables with p-values <0.2 in the bivariate analysis were included in a multivariate analysis using a Modified Poisson Regression model to identify determinants of adverse maternal-fetal outcomes of obstructed labor.

 Results:

The most commonly reported adverse maternal outcome was puerperal sepsis (21, 55.4%), while birth asphyxia (65, 70.7%) was the commonest adverse fetal outcome. Being referred from a lower health center, non-use of partograph during labor, history of herbal medicine use, and visiting a traditional birth attendant were strongly correlated with the adverse maternal-fetal outcomes (p-value = <0.001).

 Conclusions: 

This study revealed a high prevalence of adverse maternal-fetal outcomes associated with obstructed labor. Being referred from a lower health facility, non-use of partograph during labor, history of herbal medicine use, and visiting a traditional birth attendant were associated with adverse maternal-fetal outcomes among women with obstructed labor. Sepsis, perineal tears, birth asphyxia, and stillbirth were the commonest adverse outcomes of obstructed labor.

 Recommendation:

This calls for improving the referral system from lower health facilities, improving infrastructure to support timely access to critical emergency obstetric care, and emphasizing the need for patrograph use during labor.