Patterns and factors associated with electrolyte derangement among women with obstructed labour in Mulago Hospital

Abstract

Background: Electrolyte derangement is one of the most common complications of obstructed labour and is a major cause of maternal and perinatal morbidity and mortality especially in developing countries such as Uganda. At Mulago hospital, many women are predisposed to getting electrolyte derangement from obstructed labour; however they are not routinely screened but are given any available intravenous fluids regardless of the patients’ needs. Therefore electrolyte derangement may not be diagnosed and properly managed leading to life threatening conditions such as cardiac arrhythmias or cardiopulmonary arrest, fetal distress and low Apgar score. Objective: The main objective of this study was to assess the prevalence, patterns and factors associated with electrolyte derangement among women with obstructed labour in Mulago National Referral Hospital conducted between July/2014 to Dec/2014. Methods: This was a cross-sectional study conducted at Mulago National Referral Hospital (MNRH) labour ward. A total of 299 mothers with obstructed labour that had come to deliver were studied. Data was collected on socio-demographic characteristics, obstetric and patient related factors using structured questionnaires administered by trained research assistants. Blood was withdrawn for analysis of serum electrolytes levels. The collected data was entered in Epidata v3.1 then analysed using Stata v 12. Logistic regression was done to determine the factors associated with electrolyte derangement Results: Out of the 299 participants recruited, 152 (50.8%) had electrolyte derangement. The most common type of derangement was for sodium 95/152 (62.5%).The pattern of specific electrolyte derangement were: hyperkalemia was 11/39(28.21%), hyponatremia 124/125 (99.2%) and hypochloremia 18/24 (75.0%). Primigravida women were almost four folds more likely to xi

develop electrolyte derangement than multiparous women (AOR=3.71, 95%CI: 1.23-11.15, p=0.02). However, women aged ≤19 years were less likely to develop electrolyte derangement compared to older women (≥30years) (AOR=0.39, 95%CI: 0.16-0.96, p=0.04). Conclusion: The prevalence of electrolyte derangement among mothers with obstructed labour was high. The most common pattern of electrolyte disorder was hyponatremia. Primigravida and older age (≥30years) were risk factors for electrolyte derangement in obstructed labour.