• African health sciences · Sep 2020

    Case Reports

    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.

    • Nnabuike Chibuoke Ngene and Jagidesa Moodley.
    • Department of Obstetrics and Gynaecology, Klerksdorp Hospital, Klerksdorp, South Africa.
    • Afr Health Sci. 2020 Sep 1; 20 (3): 123712401237-1240.

    BackgroundInduction 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.MethodsA 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.ResultsAt the ensuing caesarean delivery, uterine rupture/tear was diagnosed, and the patient died due to haemorrhage during an emergency hysterectomy.ConclusionThis 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.© 2020 Ngene NC et al.

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