Abstract:
Background: Dystocia of active first stage of labor `has a notable contribution to maternal and neonatal morbidity and mortality. It is a main reason for the increasing rate of cesarean delivery in the world. Majorities of the determinants of dystocia in active first stage of labor could be modifiable, and may vary across the settings and over time trend. So, contextual scientific studies in this regard are imperative for evidence-based interventions. However, there was a dearth of evidence about extent and contributing factors of dystocia of active first stage of labor in Ethiopia.
Objective: This study aims to assess the incidence and predictors of dystocia of active first stage of labor among laboring mothers at debremarkos comprehensive specialized hospital Amhara, northwest Ethiopia, 2022.
Methods: Prospective cross-sectional study was conducted from October 20 to January 4/2023. A total of 656 laboring women were included with response rate of 94.5%. The study participants were selected by using a systematic random sampling technique at Debremarkos comprehensive specialized hospital Amhara, northwest Ethiopia. Data were collected through, observation, interview using a pretested structured questionnaire, and document review. The data were entered with Epi-data version 4.2 and analyzed by SPSS version 26. Both descriptive and inferential analyses were carried out. Binary Logistic Regression was fitted and the level of significance was declared based on Adjusted Odds Ratio (AOR) with its 95% Confidence Interval (CI) and p-value of ≤0.05.
Result: The overall incidence of dystocia of AFSOL is 35.3 %( 95%CI: 31.9, 39.2). Induction of labor (AOR: 2.4; 95%CI: 1.12. 5.05), admitting of laboring mother with cervical dilation of<4cm (AOR: 3.5; 95%CI: 2.06, 6.06), poor health care provider support (AOR: 7.5; 95%CI: 4.15, 13.54), and caffeine intake >200mg (≈≥3cup of coffee) (AOR: 3.5; 95%CI: 1.69, 7.19) identified as positive relation with DAFSOL. Drinking of linseed (AOR: 0.29; 95%CI: .14, .58), ANC follow up (AOR: .23; 95%CI: .08, .62), and ambulation during AFSOL (AOR: 0.31; 95%CI: .13, .72) is preventive factor of DAFSOL.
Conclusion: The incidence of DAFSOL is high relative to other studies. Having ANC follow up, eating/drinking of linseed at the onset of labor pain and ambulating during active first stage of labor is identified as protective factors for dystocia of active first stage of labor. Whereas, drinking of three or more cup of coffee per day during pregnancy, induction of labor, poor health care provider support during AFSOL and admitting of the laboring mothers while cervical dilation <4cm are positive predictors of dystocia of active first stage of labor. Adopting WHO labor care guide and encouraging health care providers to practice evidence based practice regarding the management of active 1st stage of labor and good patient handling during the laboring process is recommended to minimize the diagnosis of DAFSOL and its unnecessary interventions.
