FETO-MATERNAL OUTCOME

Abstract

Background: Trial of labour is a clinical test to assess the adequacy of pelvis andability of fetus and mother to withstand labour. If progressive changes in dilation and station donot occur, a cesarean delivery is performed. Objective: Feto-maternal outcome after trial oflabour in women with gestational age b/w 37 to 42 weeks. Study Design: Cross sectional study.Setting: Department of Obs/ Gyn unit-I Liaquat University Hospital Hyderabad. Duration ofStudy: One year from 01-02-2009 to 31-01-2010. Subjects and Methods: 100 pregnant women,with gestational age between 37-42 weeks, who underwent trial of labour at labour ward,Obs/Gyn Unit-1 Liaquat University Hospital, after fulfilling the inclusion criteria were included inthe study. Detailed history and examination including abdominal and pelvic examination as wellas Ultrasound for fetal well being was performed. Fetal monitoring was done by auscultation andCTG. Partogram was maintained to observe the progress of labour. Those who progressed withtrial either delivered normally or with the help of instruments and those who did not progress weredelivered by C-section. After delivery, mothers were watched for any postpartum complicationand condition of neonates was assessed by APGAR score. Results: Out of 100 women includedin this study 58% delivered vaginally, 31 % delivered by cesarean section and 11 % hadinstrumental deliveries. Labour was induced in 34%, augmented in 34% and 32% hadspontaneous labour. 77.0% babies had apgar score > 5(7.1±0.72), 16% < 5(3.68±2.18) and 6%were still birth. 81% mothers had no complication during or after delivery, whereas 19 developedcomplications and these were 12 Genital tract traumas, 5 postpartum haemorrhage, one uterinerupture and one retained placenta. There was no statistically significant difference (P=0.42)when mode of delivery was compared with the trial of labour. However augmentation of labourwas associated with increased rate of maternal complications when maternal outcome wascompared with the type of labour (P=0.03). Conclusions: Trial of labour in carefully selectedwomen with high probability to deliver their babies vaginally decreases the rate of LSCS, therebyreducing the maternal morbidity and mortality associated with it. However augmentation oflabour is associated with increased rate of maternal complications as compared to spontaneousor induced labour.