Rabecca M., 17

Rebecca is a 17-year-old girl and the firstborn in a family of seven children. Her father, the sole breadwinner, depends on casual labor, earning an irregular and insufficient income that cannot adequately meet the family’s basic needs. As the eldest child, Rebecca bears significant responsibility at home, supporting her mother with household duties and helping care for her younger siblings. The family struggles to afford essential needs such as food, education, and healthcare. Rebecca wasbrought to Kory Family Hospital with preterm labour possibly due to an infection, and while in the hospital later went in labour, got prolonged labor, lower abdominal pain, and failure to deliver vaginally. She reported strong, frequent uterine contractions accompanied by intense pelvic pressure. Her antenatal history indicated a full-term pregnancy with no known chronic medical conditions. Pelvic examination indicated a mismatch between the size of the maternal pelvis and the fetal head, with the head remaining high in the birth canal despite adequate contractions—findings consistent with cephalopelvic disproportion (CPD). Fetal heart monitoring showed distress.

Rebecca came to the hospital in labor with complaints of prolonged labor, lower abdominal pain, and inability to deliver vaginally. She reported strong and frequent uterine contractions, associated with painful pressure in the pelvis. Her antenatal history revealed a full-term pregnancy, and she was otherwise healthy, with no known chronic illnesses. On examination, the patient appeared anxious and uncomfortable. Vital signs were stable, but she exhibited signs of exhaustion from prolonged labor. Abdominal examination revealed a term-sized uterus with strong contractions, and the fetal lie was cephalic. Pelvic examination demonstrated a disproportion between the maternal pelvis and fetal head, with the fetal head high in the birth canal despite strong contractions, consistent with cephalopelvic disproportion (CPD). Fetal heart rate was monitored and showed mild signs of distress, including variability and transient decelerations. Based on the clinical findings, a diagnosis of cephalopelvic disproportion with obstructed labor was made, and the patient was prepared for an emergency cesarean section to prevent maternal and fetal complications.

The prognosis for cephalopelvic disproportion (CPD) is generally excellent if promptly recognized and managed appropriately. With timely intervention, typically by cesarean section, both mother and baby usually recover well. Without intervention, prolonged obstructed labor can lead to maternal complications such as exhaustion, postpartum hemorrhage, infection, or birth canal injury, and fetal complications such as oxygen deprivation, birth injuries, or stillbirth. With emergency C-section, as is standard practice, the outcome is usually favorable, and most mothers go on to recover fully, while babies are born healthy and without significant complications as was the case for Rabecca.