Obstetric out come of cases referred to a tertiary care hospital after trial of labour

ABSTRACT

Childbirth is a natural process but with its' inherent risk of complications. Skilled birth attendant can provide timely emergency obstetrics services. Objective of this study was to analyze fetomaternal outcome of cases referred to our hospital after trial of labour and to identify factors, which could prevent adverse obstetric outcome. This study was conducted at Obstetrics and Gynae Unit II Sir Ganga Ram hospital, Lahore. One hundred patients who were admitted through emergency after trial of labour by TBA, LHV or doctors at home or private clinics were analyzed for fetomaternal outcome. Out of hundred patients in study group 49 were Primigravida while 10 were grandmulti. About 90% of patients never had any antenatal checkup. Maximum patients [94%] were under care of TBA and LHV. 54 patients had already prolong labour out of which 38 cases were of obstructed labour. Five patients had ruptured uterus. 49 patients were delivered by caesarean section while 29 had forceps delivery. Laparotomy was carried out in four patients due to ruptured uterus out of which two had hysterectomy. There was one maternal death due to ruptured uterus. Post partum hemorrhage occurred in ten patients, while 12 had puerperal pyrexia. Regarding perinatal outcome there were 23 stillbirths, while 45 had Apgar score below 5 at five minutes. Ten babies died in first 12 hours. This study concludes that complications of labour if not timely diagnosed and rectified results in adverse fetomaternal outcome. Provision of skilled birth attendant at doorstep will be an ideal solution