Prevalence and Risk Factors of Obstructed Labor Among Pregnant Women at Selected Public Hospitals in Mogadishu- Somalia: Multi-Centered Case-Control Study

Abstract

Obstructed labor (OL) is a typical reason for maternal morbidity and mortality in sub-Saharan Africa and Southeast Asia. A retrospective case-control study was conducted to determine the prevalence and risk factors of obstructed labor among pregnant women at selected public hospitals in Mogadishu-Somalia. Methods: a retrospective case-control study was conducted to ascertain risk factors of obstructed labor among pregnant women at selected public hospitals in Mogadishu- Somalia, from 1^stJuly 2020 to 30^thDecember 2020. The study site was one of the selected public hospitals in Mogadishu- Somalia, including Banadir, SOS, Madina Daynile, and Demartino public hospitals. The Maternal Sociodemographic factors, clinical factors, and complications associated with obstructed labor were obtained from selected public and clinical data. These variables were coded numerically and computerized using statistical analysis software called statistical package for social science (SPSS) version 24). <i>Results</i>: 143 out of 960 patients were obstructed Labor prevalence of 14.8%; according to age group, 22% were 15–19 years, over 47.2% were married, had educational levels (25.52%), and patients were illiterate. The majority (89.5%) of the patients were rural dwellers with (80.2%) who came from a distance between 30-59Km. Being nulliparous (first pregnancy) was the leading cause for the patients in obstructed labor (27.27%) of all the cases group. This was followed by being referred with Obstructed Labor (OL) (72.0%) and referred from Private health facilities alone, forming about (65.0%). The fetal risk factors observed in this study were Cephalo-pelvic disproportion, with a reported (71.1%), and fetal malpresentation, with (23.8%). The dominant maternal complication type reported in this study was ruptured uterus (43.3%) among obstructed labor. The most typical fetal complication was birth Asphyxia (40.5%), although there was a significant association between demographics, Obstetrical risk factors, and the developing obstructed labor. Conclusion: This study showed a high prevalence of obstructed labor, and sociodemographic attributes and obstetrical factors are causal factors to its development. The results of this study make it clear that the Ministry of Health and other healthcare stakeholders must seek to scale up present facility-based interventions to improve maternal outcomes and lessen the effects and incidences of obstructed labor.