Surgical intervention in booked and unbooked pregnant adolescent mothers aged 12, 13 and 14 years

Summary

In this case control study, the rates of surgical intervention were determined in 340 booked and 710 unbooked pregnant adolescent mothers aged 12, 13 and 14 years, over 2 years. Of 340 mothers booked 81 (23·8 per cent) had cephalopelvic disproportion; 18 of these (5·3 per cent) suffered from obstructed labour, while 123 (17·3 per cent) of the 162 unbooked mothers (22·8 per cent) who had disproportion also suffered from obstructed labour. About half the mothers in each group achieved spontaneous vaginal delivery.

While 126 booked mothers (37·1 per cent) were delivered by caesarean section, 229 unbooked mothers (32·3 per cent) had caesarean sections. The ventouse or forceps assisted delivery rates were 10·6 and 8·7 per cent in booked and unbooked mothers respectively. Destructive operative delivery was carried out on eight unbooked patients (2·4 per cent) compared with 51 (7·2 per cent) unbooked mothers. Episiotomy was performed on about 70 and 40 per cent of booked and unbooked mothers respectively who achieved vaginal delivery, while perineal tears occurred in 16 and 12 per cent respectively.

One uterine rupture occurred as a result of caesarean section scar dehiscence in one unbooked mother. Cervical laceration, uterine atony and retained placenta were the main cause of postpartum haemorrhage in both groups.