Abstract
Background. Prolonged obstructed labour is a major cause of maternal and perinatal morbidity and mortality especially in the developing countries of the world, where the incidence is high. These complications are partly attributed to the metabolic and electrolyte derangements that are often associated with this problem. It is, therefore, important to evaluate the metabolic and electrolyte changes of these patients in a rural community in a developing country. Objective. To compare the electrolyte changes, maternal, and perinatal outcomes in patients with prolonged obstructed labour with that of normal labour in General Hospital Ikot Ekpene, Akwa Ibom State, Nigeria. Patients and Methods. This is a prospective cross-sectional case control study conducted in the Labour Ward of the General Hospital Ikot Ekpene to compare the electrolyte levels and perinatal outcome of 95 pregnant women who had prolonged labour with 105 women who had normal labour within the same period. Main Outcome Measures. Electrolyte changes, ketonuria, maternal complications, and perinatal outcome. Results. The majority of women with prolonged labour (91.6%) had major surgical interventions requiring anaesthesia. Perinatal death occurred in 12.6%, and a major life-threatening maternal complications (including two deaths) occurred in 13.7% of those with prolonged labour compared to 2.9% (with no death) in those with normal labour. Significant abnormal electrolyte changes included hyperkalemia, high urea, and creatinine as well as low bicarbonate levels were recorded. Metabolic abnormality was shown by ketonuria in 91.1% of the patients compared to 1.9% in women with normal labour. Conclusion. Women with prolonged labour in Ikot Ekpene have significant electrolyte and metabolic changes which impact adversely on the maternal and perinatal outcomes of the pregnancy. Effort should be made to correct these electrolyte and metabolic abnormalities during resuscitation of the woman in order to reduce the complications associated with such derangements.
Highlights
Obstructed labour ranked 41st in Global Burden of Disease (GBD) in 1990, representing 0.5% of the burden of all conditions and 22% of all maternal conditions [1]
A total of 8,640 deliveries were conducted during the period, and 115 were prolonged labour giving an incidence of 1 in 75 deliveries or 1.3%
The incidence of prolonged labour was more in women with low formal educational background (76.8% versus 25.7% of those educated up to primary school)
Summary
Obstructed labour ranked 41st in Global Burden of Disease (GBD) in 1990, representing 0.5% of the burden of all conditions and 22% of all maternal conditions [1]. It is well documented that prolonged obstructed labour is still a major cause of unacceptable high maternal and perinatal morbidity and mortality globally especially in the developing countries of the world. Prolonged obstructed labour is a major cause of maternal and perinatal morbidity and mortality especially in the developing countries of the world, where the incidence is high. These complications are partly attributed to the metabolic and electrolyte derangements that are often associated with this problem. To compare the electrolyte changes, maternal, and perinatal outcomes in patients with prolonged obstructed labour with that of normal labour in General Hospital Ikot Ekpene, Akwa Ibom State, Nigeria. Effort should be made to correct these electrolyte and metabolic abnormalities during resuscitation of the woman in order to reduce the complications associated with such derangements
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