Adeoye et al., J Women’s Health Care 2014, 3:3
DOI: 10.4172/2167-0420.1000160
Volume 3 • Issue 3 • 1000160
J Women’s Health Care
ISSN: 2167-0420 JWHC, an open access journal
Open Access Research Article
Obstructed Labor in South East Nigeria Revisited: A Multi-Centre Study on
Maternal Socio-Demographic and Clinical Correlates
Ileogben Sunday-Adeoye
1
*, Ike Dimejesi
1
, Robinson Onoh
2
, Okorochukwu Bartholomew
3
, Michael Ezeanochie
4
and Collins Kalu
1
1
Department of Obstetrics and Gynecology, Ebonyi State University Teaching Hospital, Nigeria
2
Department of Obstetrics and Gynecology, Federal Medical Centre, Abakaliki, Nigeria
3
Department of Obstetrics and Gynecology, Federal Medical Centre, Owerri, Nigeria
4
Department of Obstetrics and Gynecology, University of Benin Teaching Hospital Benin-city, Nigeria
Abstract
Objective: The objective was to identify the characteristics of women who developed obstructed labor, the
facilities where they were managed before the progress of labor became obstructed labor and also identify short term
morbidities associated with the condition. This study was necessitated by the burden of obstetric fstula reported in this
population previously thought not to have the challenge.
Setting: The study was conducted in 3 tertiary centers including the Federal Teaching Hospital Abakaliki, the
Ebonyi state University Teaching Hospital and Federal Medical Centre Owerri.
Population: This study involved 225 consecutive parturient managed for obstructed labor in 3 tertiary hospitals
in southeast Nigeria.
Method: This was a retrospective study conducted between January 2004 and December 2008.
Results: Most of the women were between 20-34 years old and more than half (55.1%) had only primary or no
formal education. About 33% have not delivered before, while about one quarter (26.7%) had 5 or more previous
deliveries. Majority (62.7%) were managed in private maternity homes before referral while 27.6% were referred from
informal care providers like churches. Most women (55.6%) spent between 24-47 hours in labour before they were
referred. Emergency caesarean section was performed in 81.8% of cases while repair of uterine rupture was done in
11.6%. When asked about the place of their last delivery 25.3% reported it was at an informal provider’s facility while
27 (12%) were in private maternities.
Conclusion: There is need to eliminate the existence and patronage of informal maternity care providers while
strengthening the capacity of private maternity facilities to manage labor in order to reduce the problem of obstructed
labor.
*Corresponding author: Dr Ileogben Sunday-Adeoye, Department of obstetrics
and gynaecology Ebonyi State University Teaching Hospital, Nigeria. Tel;
2348037971503; E-mail: juladeoye@yahoo.com
Received March 01, 2014; Accepted April 23, 2014; Published April 29, 2014
Citation: Adeoye IS, Dimejesi I, Onoh R, Bartholomew O, Ezeanochie M, et al.
(2014) Obstructed Labor in South East Nigeria Revisited: A Multi-Centre Study on
Maternal Socio-Demographic and Clinical Correlates. J Women’s Health Care 3:
160. doi:10.4172/2167-0420.1000160
Copyright: © 2014 Adeoye IS, et al. This is an open-access article distributed
under the terms of the Creative Commons Attribution License, which permits
unrestricted use, distribution, and reproduction in any medium, provided the
original author and source are credited.
Keywords: Obstructed labor; Clinical correlates; Nigeria
Introduction
Obstructed labor remains a major cause of maternal morbidity and
mortality worldwide in developing countries including Nigeria [1-3].
It is still a major public health problem in many developing countries
and consumes scarce resources budgeted for healthcare. Labour is
considered obstructed when the presenting part of the fetus cannot
progress into the birth canal, despite strong uterine contractions [4].
Several interventions, such as advocacy for the use of the partograph
to monitor labor and the provision of emergency obstetric care services
have been proposed to reduce the scourge of obstructed labor and its
sequelae. However, recent data suggests the prevalence remains high
in sub Saharan Africa and Nigeria [5-7]. Perhaps there may be other
factors and variables that seem to make obstructed labor a persistent
and intractable condition unresponsive to interventions targeted at
health facilities in developing countries.
Tis study was designed to identify the socio-demographic and
clinical correlates of women managed for obstructed labor in three
tertiary care facilities in south eastern Nigeria. Te objective was to
identify the characteristics of these women who developed obstructed
labor, the facilities where they were managed before the progress of
labor became obstructed labor and also identify short term morbidities
associated with the condition. Te identifcation of the facilities where
the women were managed in labor before the progress was allowed to
obstruct will facilitate the development of appropriate or additional
interventions that may modify community/individual factors that
are in operation outside health facilities which contributes to the
development of obstructed labor.
Methods
A multi-centre retrospective cross sectional study from January
2004 to December 2008 among 225 consecutive parturient who were
referred and managed for obstructed labor in 3 tertiary institutions from
South East Nigeria. It was conducted at the Department of Obstetrics
and Gynecology in Ebonyi State University Teaching Hospital, Federal
Medical Centre Abakaliki and Federal Medical Centre Owerri, all
located in south east Nigeria. Tey serve a population of about 4.5
million people as the apex referral health Institution and conduct a
combined total of about 3,000 deliveries annually. Patients are referred
to the obstetric units of these centers from Government health centers,
private hospitals and informal maternal health care providers such as
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ISSN: 2167-0420
Journal of Women's Health Care