The hazards of conducting induction of labour in high-risk pregnancies at district hospitals in low- and middle-income countries: lessons to learn from a case report.

Abstract:

Background:Induction of labour (IOL) is an obstetric procedure that should be conducted in a healthcare facility with the capacity to provide optimal care based on the patient risk status. Inadequate monitoring, untimely procedure and lack of readily available and experienced medical staff to participate in the care of the patient undergoing induction are hazardous with snowball effects. Methods:A 38-year-old G4P2+1 had IOL because of oligohydramnios at term in a district hospital. The procedure was inadequately monitored and fetal demise occurred. The duration of second stage was prolonged and sequential use of vacuum and forceps deliveries were unsuccessfully performed. Results:At the ensuing caesarean delivery, uterine rupture/tear was diagnosed, and the patient died due to haemorrhage during an emergency hysterectomy. Conclusion:This report highlights important clinical lessons on IOL in a high-risk pregnancy. The timelines for monitoring during IOL, particularly when there is fetal demise in labour, are proposed.

journal_name

Afr Health Sci

journal_title

African health sciences

authors

Ngene NC,Moodley J

doi

10.4314/ahs.v20i3.27

subject

Has Abstract

pub_date

2020-09-01 00:00:00

pages

1237-1240

issue

3

eissn

1680-6905

issn

1729-0503

pii

jAFHS.v20.i3.pg1237

journal_volume

20

pub_type

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