Ruth I., 20

Ruth is an only child who lives with her mother and paternal grandmother in a two-room mud-walled house. Her father died in 2014, and the family was later displaced from their home by paternal relatives. She completed KCSE in 2022 but could not pursue polytechnic training due to financial constraints. She later worked as a house help in Nairobi and became the family’s main provider, but lost her job after becoming pregnant and returned home. Her grandmother, a peasant farmer, is currently the household’s sole breadwinner. Ruth discovered her pregnancy at five months during a routine visit at Edna Hospital, having been on family planning and therefore not suspecting pregnancy. She subsequently enrolled for ANC at Busia Sub-County Hospital and attended regularly. The pregnancy progressed beyond the expected delivery date, and she developed prolonged labour pains and headaches. She was initially managed at Sega Mission Hospital for five days before referral to Siaya County Referral Hospital. Assessment revealed failure of fetal descent due to cephalopelvic disproportion (CPD), resulting in arrested descent, necessitating an emergency caesarean section for safe delivery.

Ruth presented to the hospital with complaints of abdominal pains radiating to the back, she went into labour but her birthcanal was small which warranted an emergency caesarean surgery. She successfully underwent the procedure and taken to the ward for post operation management. In the ward she was administered ceftriaxone, paracetamol, plastic, among other drugs. She was eventually discharged on orals with a follow up clinic booked for her.

Ruth was diagnosed with cephalopelvic disproportion, which prevented a safe vaginal delivery and necessitated an emergency Caesarean section. The timely surgical intervention helped prevent potentially serious complications associated with obstructed labour. Following appropriate obstetric care and postoperative management,Ruth's condition is stable and she is expected to recover well. The prognosis is good, provided she continues with follow-up care, adheres to medical advice, and receives adequate nutritional and psychosocial support during her recovery period.