Early versus late presentation in labour by parturient women at a tertiary facility in North Central Nigeria: A cross-sectional study

Abstract

Background: Adequate intrapartum care is important in modulating pregnancy outcome through prevention, early recognition and appropriate treatment of intrapartum complications. Aim: To compare labour outcome following early to that of late presentation in labour. Methods: A comparative study at a tertiary hospital in North central Nigeria. Participants were pregnant women who presented early (cervical dilatation ≤ 5cm) or late (cervical dilation 9 or 10cm) at the study site with singleton, live foetus at ≥28weeks gestation. Deliveries before arrival at the delivery room were excluded from the study. Data was obtained from the hospital delivery records while data management was performed with SPSS version 21.0; p-value <0.05 was significant. Results: Out of the 8,645 deliveries, 5,809 (67.2%) presented early while 2,836 (32.8%) presented late in labour. Late presentation was higher among booked women (1716 vs. 1120; p<0.001) as well as prior treatment and presentation after onset of complications (1964 vs. 872; p<0.001). Labour interventions including augmentation of labour (2718 vs. 316; p<0.001), episiotomy (2319 vs. 949; p<0.001), assisted breech delivery, ventouse, forceps and caesarean deliveries were higher for early while obstructed labour (95 vs. 238) was higher for late presentation. The perinatal mortality was 78/1,000 and 192/1,000 live birth for early and late presentations in labour. Conclusion: Late presentation in labour is associated with higher perinatal mortality; antenatal clinic health education should emphasize early presentation in labour while admissions into health institutions should be regulated based on available manpower and facilities for patient management.