Labour outcome in patients admitted in the second stage of labour at Jos University Teaching Hospital, Jos, Nigeria

Abstract

Context: Unsupervised or poorly monitored labour is associated with increased maternal and neonatal complications. Late presentation in labour is common place in this part of the world.

Objective: To determine the reasons for coming in second stage of labour and compare the labour outcome with those admitted in the first stage of labour.

Materials and Methods: This was a case control study conducted at the Jos University Teaching Hospital between September and November 2012.

Results: Of the 617 total deliveries, 156 (25.3%) were admitted in second stage of labour. Majority of women (38.57%), (10.00%), (8.57%) stated transportation difficulties, fast progress of labour and husband not around respectively as the reason for coming in second stage of labour. Maternal complications like lower genital laceration (25.7% vs 8.6%), postpartum haemorrhage (7.1% vs 2.1%), and ruptured uterus (2.1%) were more common amongst the cases than the control. The total mean blood loss was similar in both groups. Complications of sickle cell crises, eclampsia, and anaemia including chorioamnionitis were found only among the cases. There were more spontaneous vagina deliveries amongst the cases while caesarean section and use of episiotomy were more amongst the control (P < 0.01). Instrumental delivery was similar in the two groups. Perinatal complications like fresh stillbirths (5.0%), early neonatal deaths (2.10%), birth asphyxia (5.4% vs 3.6%) and the need for admissions in special care baby unit (3.4% vs 0.7%) were more amongst the cases than the control.

Conclusions: This study identified transportation problems, fast progress of labour, absence of husband at home when labour starts as major reasons for presenting in second stage of labour. Presenting in second stage of labour was associated with worse labour outcome.

Keywords: Maternal complications; perinatal complications; presentation in second stage of labour; reasons