Ann C., 16

Ann is a 16-year-old girl from a low socio-economic background. She lives in a low-income household where access to basic necessities such as adequate food, clean water, proper housing, and education is limited. Her family depends on irregular and low-paying jobs or small subsistence activities, resulting in unstable and insufficient income to meet daily needs. Because of financial hardship, the family often struggles to afford transport to health facilities, consultation fees, laboratory tests, and prescribed medications. Consequently, medical care is frequently delayed until conditions become severe. In some instances, they resort to home remedies, traditional treatments, or local drug shops, which may not provide appropriate or adequate care. Limited health awareness, poor access to health information, and long distances to healthcare facilities further contribute to delayed care-seeking, increasing Ann’s risk of complications and poor health outcomes. Ann is a primigravida, meaning she is pregnant for the first time. She presented at term with a history of lower abdominal pain radiating to the back, increasing in frequency and intensity, and not responding to analgesics. She also reported leakage of fluid and reduced fetal movements one day prior to admission. On examination, she was found to be 4 cm dilated for several hours without adequate progress. Grade two meconium-stained liquor was noted, indicating possible fetal distress. Based on these findings, she was diagnosed with prolonged labour likely due to cephalopelvic disproportion, accompanied by fetal distress. The medical team recommended an emergency Caesarean section to safeguard the lives of both the mother and the baby and to prevent further complications.

Ann came to the hospital in labour with complains of, draining liquid for last three days, reduced fetal movement and severe abdominal pain. On examination and laboratory investigation, she had LAP radiating to the back, increasing in frequency and intensity not responding to analgesic, was at 4cm cervical dilated for several hours and Meconium grade 2 was noticed. Based on investigation, she was diagnosed with prolonged labour/ cephalopelvic disproportion in fetal distress. The medical team recommended for emergency ceaserian section for the purpose of avoiding severe complications and to save lives of the mother and the baby. Operation was successful both mother and the baby are doing well and discharged on good condition.

Upon examination of Ann, the findings were consistent with prolonged labour likely secondary to cephalopelvic disproportion. The lack of progress in labour combined with signs of fetal distress placed both the mother and baby at significant risk. An emergency Caesarean section was therefore medically indicated to prevent complications such as fetal asphyxia, maternal exhaustion, infection, or uterine rupture With timely surgical intervention, Ann’s prognosis is good. Emergency Caesarean section significantly reduces the risk of maternal and fetal complications in cases of prolonged labour and CPD. Postoperative recovery is expected to be favorable with proper monitoring, infection prevention, pain management, and follow-up care. The baby’s prognosis will depend on the severity and duration of fetal distress prior to delivery, but early intervention greatly improves outcomes