Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2011

Open Access 01-12-2011 | Research article

Individual and health facility factors and the risk for obstructed labour and its adverse outcomes in south-western Uganda

Authors: Jerome K Kabakyenga, Per-Olof Östergren, Eleanor Turyakira, Peter K Mukasa, Karen Odberg Pettersson

Published in: BMC Pregnancy and Childbirth | Issue 1/2011

Login to get access

Abstract

Background

Obstructed labour is still a major cause of maternal morbidity and mortality and of adverse outcome for newborns in low-income countries. The aim of this study was to investigate the role of individual and health facility factors and the risk for obstructed labour and its adverse outcomes in south-western Uganda.

Methods

A review was performed on 12,463 obstetric records for the year 2006 from six hospitals located in south-western Uganda and 11,180 women records were analysed. Multivariate logistic regression analyses were applied to control for probable confounders.

Results

Prevalence of obstructed labour for the six hospitals was 10.5% and the main causes were cephalopelvic disproportion (63.3%), malpresentation or malposition (36.4%) and hydrocephalus (0.3%). The risk of obstructed labour was statistically significantly associated with being resident of a particular district [Isingiro] (AOR 1.39, 95% CI: 1.04-1.86), with nulliparous status (AOR 1.47, 95% CI: 1.22-1.78), having delivered once before (AOR 1.57, 95% CI: 1.30-1.91) and age group 15-19 years (AOR 1.21, 95% CI: 1.02-1.45). The risk for perinatal death as an adverse outcome was statistically significantly associated with districts other than five comprising the study area (AOR 2.85, 95% CI: 1.60-5.08) and grand multiparous status (AOR 1.89, 95% CI: 1.11-3.22). Women who lacked paid employment were at increased risk of obstructed labour. Perinatal mortality rate was 142/1000 total births in women with obstructed labour compared to 65/1000 total births in women without the condition. The odds of having maternal complications in women with obstructed labour were 8 times those without the condition. The case fatality rate for obstructed labour was 1.2%.

Conclusions

Individual socio-demographic and health system factors are strongly associated with obstructed labour and its adverse outcome in south-western Uganda. Our study provides baseline information which may be used by policy makers and implementers to improve implementation of safe motherhood programmes.
Literature
1.
Neilson JP, Lavender T, Quenby S, Wray S: Obstructed labour. Br Med Bull. 2003, 67: 191-204. 10.1093/bmb/ldg018.CrossRefPubMed
2.
Gessessew A, Mesfin M: Obstructed labour in Adigrat Zonal Hospital, Tigray Region, Ethiopia. Ethiop J Health Dev. 2003, 17 (3): 175-180.
3.
WHO: The World health report: 2005: make every mother and child count. 2005, Geneva: World Health Organization, 230-
4.
Nwogu-Ikojo EE, Nweze SO, Ezegwui HU: Obstructed labour in Enugu, Nigeria. J Obstet Gynaecol. 2008, 28 (6): 596-599. 10.1080/01443610802281682.CrossRefPubMed
5.
Ali AA, Adam I: Maternal and perinatal outcomes of obstructed labour in Kassala hospital, Sudan. J Obstet Gynaecol. 2010, 30 (4): 376-377. 10.3109/01443611003672096.CrossRefPubMed
6.
Mathai M: The partograph for the prevention of obstructed labor. Clin Obstet Gynecol. 2009, 52 (2): 256-269. 10.1097/GRF.0b013e3181a4f163.CrossRefPubMed
7.
Thaddeus S, Maine D: Too far to walk: maternal mortality in context. Soc Sci Med. 1994, 38 (8): 1091-1110. 10.1016/0277-9536(94)90226-7.CrossRefPubMed
8.
Essendi H, Mills S, Fotso JC: Barriers to Formal Emergency Obstetric Care Services' Utilization. J Urban Health. 2010, 88 (Suppl 2): S356-369.
9.
Pitchforth E, van Teijlingen E, Graham W, Dixon-Woods M, Chowdhury M: Getting women to hospital is not enough: a qualitative study of access to emergency obstetric care in Bangladesh. Qual Saf Health Care. 2006, 15 (3): 214-219. 10.1136/qshc.2005.017285.CrossRefPubMedPubMedCentral
10.
Kyomuhendo GB: Low use of rural maternity services in Uganda: impact of women's status, traditional beliefs and limited resources. Reprod Health Matters. 2003, 11 (21): 16-26. 10.1016/S0968-8080(03)02176-1.CrossRefPubMed
11.
Raikes A: Women's health in east Africa. Soc Sci Med. 1989, 28 (5): 447-459. 10.1016/0277-9536(89)90100-7.CrossRefPubMed
12.
Pettersson KO, Christensson K, de Freitas Eda G, Johansson E: Strategies applied by women in coping with ad-hoc demands for unauthorized user fees during pregnancy and childbirth. A focus group study from Angola. Health Care Women Int. 2007, 28 (3): 224-246. 10.1080/07399330601179885.CrossRefPubMed
13.
Granja AC, Machungo F, Bergstrom S: Avoidability of maternal death in Mozambique: audit and retrospective risk assessment in 106 consecutive cases. Afr J Health Sci. 2000, 7 (3-4): 83-87.PubMed
14.
Orach CG: Maternal mortality estimated using the Sisterhood method in Gulu district, Uganda. Trop Doct. 2000, 30 (2): 72-74.PubMed
15.
Mbonye AK, Asimwe JB, Kabarangira J, Nanda G, Orinda V: Emergency obstetric care as the priority intervention to reduce maternal mortality in Uganda. Int J Gynaecol Obstet. 2007, 96 (3): 220-225. 10.1016/j.ijgo.2006.12.017.CrossRefPubMed
16.
Jeppsson A: SWAp dynamics in a decentralized context: experiences from Uganda. Soc Sci Med. 2002, 55 (11): 2053-2060. 10.1016/S0277-9536(01)00345-8.CrossRefPubMed
17.
Orinda V, Kakande H, Kabarangira J, Nanda G, Mbonye AK: A sector-wide approach to emergency obstetric care in Uganda. Int J Gynaecol Obstet. 2005, 91 (3): 285-291. 10.1016/j.ijgo.2005.07.023. discussion 283-284CrossRefPubMed
18.
Ministry of Finance and Economic Development U: Millennium Development Goals Report for Uganda 2010. Special theme: Accelerating progress towards improving maternal health. 2010, Kampala: Ministry of Finance and Economic Development, 85-
19.
Ministry of Health U: Health Sector Strategic Plan II 2005/06 - 2009/10. 2005, Kampala: Ministry of Health, 14-15.
20.
Rutebemberwa E, Pariyo G, Peterson S, Tomson G, Kallander K: Utilization of public or private health care providers by febrile children after user fee removal in Uganda. Malar J. 2009, 8: 45-10.1186/1475-2875-8-45.CrossRefPubMedPubMedCentral
21.
Melah GS, El-Nafaty AU, Massa AA, Audu BM: Obstructed labour: a public health problem in Gombe, Gombe State, Nigeria. J Obstet Gynaecol. 2003, 23 (4): 369-373. 10.1080/01443610310001119510.CrossRefPubMed
22.
Ozumba BC, Uchegbu H: Incidence and management of obstructed labour in eastern Nigeria. Aust N Z J Obstet Gynaecol. 1991, 31 (3): 213-216. 10.1111/j.1479-828X.1991.tb02783.x.CrossRefPubMed
23.
Uganda Bureau of Statistics and Macro International Inc: Uganda Demographic and Health Survey 2006. 2007, Calverton, Maryland, USA, UBOS and Macro International Inc, 119-181.
24.
Lawn JE, Cousens S, Zupan J: 4 million neonatal deaths: when? Where? Why?. Lancet. 2005, 365 (9462): 891-900. 10.1016/S0140-6736(05)71048-5.CrossRefPubMed
25.
Kaye D, Mirembe F, Aziga F, Namulema B: Maternal mortality and associated near-misses among emergency intrapartum obstetric referrals in Mulago Hospital, Kampala, Uganda. East Afr Med J. 2003, 80 (3): 144-149.PubMed
26.
Nahar S, Banu M, Nasreen HE: Women-focused development intervention reduces delays in accessing emergency obstetric care in urban slums in Bangladesh: a cross-sectional study. BMC Pregnancy Childbirth. 2011, 11 (1): 11-10.1186/1471-2393-11-11.CrossRefPubMedPubMedCentral
27.
AbouZahr C: Global burden of maternal death and disability. Br Med Bull. 2003, 67: 1-11. 10.1093/bmb/ldg015.CrossRefPubMed
28.
World Health Organization partograph in management of labour. World Health Organization Maternal Health and Safe Motherhood Programme. Lancet. 1994, 343 (8910): 1399-1404.
29.
Ogwang S, Karyabakabo Z, Rutebemberwa E: Assessment of partogram use during labour in Rujumbura Health Sub District, Rukungiri District, Uganda. Afr Health Sci. 2009, 9 (Suppl 1): S27-34.PubMedPubMedCentral
30.
Oladapo OT, Daniel OJ, Olatunji AO: Knowledge and use of the partograph among healthcare personnel at the peripheral maternity centres in Nigeria. J Obstet Gynaecol. 2006, 26 (6): 538-541. 10.1080/01443610600811243.CrossRefPubMed
31.
Fawole AO, Adekanle DA, Hunyinbo KI: Utilization of the partograph in primary health care facilities in southwestern Nigeria. Niger J Clin Pract. 2010, 13 (2): 200-204.PubMed
32.
Fawole AO, Fadare O: Audit of use of the partograph at the University College Hospital, Ibadan. Afr J Med Med Sci. 2007, 36 (3): 273-278.PubMed
33.
Chhabra S, Gandhi D, Jaiswal M: Obstructed labour - a preventable entity. J Obstet Gynaecol. 2000, 20 (2): 151-153. 10.1080/01443610062913.CrossRefPubMed
34.
Adhikari S, Dasgupta S, Sanghamita M: Management of obstructed labour: aretrospective study. J Obstet Gynec India. 2005, 55 (No 1): 48-51.
35.
van Roosmalen J: Safe motherhood: cesarean section or symphysiotomy?. Am J Obstet Gynecol. 1990, 163 (1 Pt 1): 1-4.CrossRefPubMed
36.
Moodley J, Kenneth B, eds: Proceedings of a workshop on prolonged labour: Durban, South Africa November 2004. 2004, Durban and Stolkholm: University of KwaZulu-Natal and Karolinska Institutet
Metadata
Title
Individual and health facility factors and the risk for obstructed labour and its adverse outcomes in south-western Uganda
Authors
Jerome K Kabakyenga
Per-Olof Östergren
Eleanor Turyakira
Peter K Mukasa
Karen Odberg Pettersson
Publication date
01-12-2011
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2011
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/1471-2393-11-73

Other articles of this Issue 1/2011

BMC Pregnancy and Childbirth 1/2011 Go to the issue

Research article

A multi-centre cohort study shows no association between experienced violence and labour dystocia in nulliparous women at term

Research article

Systematic review of the magnitude and case fatality ratio for severe maternal morbidity in sub-Saharan Africa between 1995 and 2010

Research article

Antenatal care in practice: an exploratory study in antenatal care clinics in the Kilombero Valley, south-eastern Tanzania

Research article

Prevalence, predictors and perinatal outcomes of peri-conceptional alcohol exposure - retrospective cohort study in an urban obstetric population in Ireland

Study protocol

Limiting weight gain in overweight and obese women during pregnancy to improve health outcomes: the LIMIT randomised controlled trial

Research article

Concurrent analysis of choice and control in childbirth