Fetal outcomes in antenatal women admitted with a diagnosis of prolonged latent phase of labour at university teaching hospital Lusaka

Abstract

Background: The latent phase of labour is poorly understood and duration of this phase is significantly difficult to measure. Prolonged latent phase (PLP) accounts for abnormalities in both nulliparous and multiparous mothers and is associated with increased risks of obstetric interventions and poor fetal outcomes. Objectives: This study aimed to determine fetal outcomes in women admitted with a diagnosis of PLP at the UTH. Methods: A case control study of ratio 1:1 comprising 171 women with PLP and 168 with normal labour was examined at the UTH from July 2015 to October 2015. An investigator administered questionnaire was used to collect data along with medical records of neonates and mothers. Bivariate analysis and multiple logistic regression was carried out to compare fetal outcomes in cases and controls. Results: There were 12.3% admissions to NICU from among women with PLP and none from controls (with normal labour). Furthermore, 9.9% of newborns with Apgar score < 7 were in women with PLP and 1.2% in controls. Caesarean section and post-partum hemorrhage was more frequent in women with PLP than controls: 15 (8.8%) vs. 2 (1.2 %) and (5.8% vs. 1.2%) respectively. Moreover, younger mothers had marginally higher odds of PLP [Odds Ratio (OR) 1.10, 95% CI 1.05 – 1.15, P-value < 0.01] and women with parity 0 had over 12 times increased odds for PLP (OR 12.29, 95% CI 4.62 – 32.67, P-value < 0.01). Conclusion: This study has shown that prolonged latent phase of labour is a predictor of labour dystocia and neonatal morbidity. It is manifested by higher intervention rates such as augmentation and operative deliveries amongst women with PLP than controls. Babies delivered following PLP require more neonatal attention than controls. Therefore, all women with PLP should be referred to UTH to reduce on morbidity and mortality.