Health Seeking Behavior of Women with Obstructed Labour Attending in Tertiary Level Hospitals of Dhaka City

Dilruba Akter, Assistant Professor (Obs and Gynae), Institute of Child
and Mother Health Matuail, Dhaka, Bangladesh

Sameena Chowdhury, Professor and Head of the Department (Obs and Gynae), Institute of Child and Mother Health Matuail, Dhaka, Bangladesh

Anisur Rahman, Assistant Registrar (Anaesthesiology Department), Dhaka Medical College Hospital, Dhaka, Bangladesh

Abstract:
Objective: To explore the knowledge, attitude and practices of mothers/ caregivers contributing to obstructed labour, to determine the causes of obstructed labour, to find out the mode of delivery and to identify the maternal consequences and foetal outcome.

Methods: This was a cross-sectional study done in two tertiary level hospitals (ICMH and DMCH) over a period of 6 months from July to December 2002. One hundred patients with obstructed labor attended consecutively were included in this study. Structured questionnaire was used for data collection.

Results: One hundred pregnant women with obstructed labour have been studied. Fifty percent of patients came from rural area, 72% were living in the kaccha house, 52% of them had noformal education, 82% of patient’s husband were daylaborur and and cultivator.Primigravida were 52%, 95% of patients had no knowledge about pre-conceptional health check up.Fifty percent had no knowledge about antenatal care, 96% had no knowledge about the consequences of obstructed labour. Eighty percent of the patients had negative attitude towards hospital delivery.In 65% cases delivery were tried on bare floor without sheet, per-vaginal examination was done by ungloved hand in 93% cases, 90% deliveries
were attended by TBA, P/V examination was done 5-8 times in 55% cases, 57% cases used unhygienic material as a lubricant during P/V examination., drugs used for augmentation of labour in 52% cases. Seventy percent of patients attended in the hospital after 24 hours of labour pain, 89% presented with foetal distress and 90% patients were delivered by caesarean section, maternal morbidities were rupture uterus (5%), VVF (2%), puerperal sepsis (20%), wound infection (84%) and one patient was died due to ruptured uterus. Fifty two percent newborn were asphyxiated, 43% were stillborn and perinatal mortality were 53%.

Conclusion: The result showed poor birth preparedness for safe delivery, poor antenatal attendance and unhygienic practices by unskilled birth attendance during delivery and high foetal morbidity and mortality and high maternal morbidities.

Keywords: KAP, Obstructed labour, Dhaka.

Scroll Down to Read the Full Editorial or Download PDF -->