Abstract
This report describes data on the referral by Khuandon Hospital in Satun Province
of patients experiencing unsuccessful labor in fiscal years 2005-2007. The objectives of
the study were to compile knowledge for planning in order to improve patient care and
referrals. The methodology of the study was to review the 122 cases of unsuccessful
delivery in the labor division of Khuandon Hospital, focusing on the rate of unsuccessful
labor, the characteristics of the patients experiencing unsuccessful labor and the patterns
of delivery after they were referred to a general hospital in the province. The findings
were as follows: the unsuccessful labor rate was 15.74 percent among the total study population
of 775 pregnant women. The patterns of delivery at Satun Hospital, to which the women had been referred, resulted in normal labor including breech-assisted cases
(41.80%), caesarean section (40.98%) (or 6.45% of the total of 775 pregnant women, which
was similar to the data of the Office of Health Service Development, Ministry of Public
Health (5.46 - 7.04%). The majority of patients experiencing unsuccessful labor were
primigravidae. The causes of referrals ranged respectively from pregnancy-induced hypertension
(PIH), cephalopelvic disproportion (CPD), prolonged stage, and fetal distress,
to premature labor and breech presentation. With regard to the patterns of delivery after
the referrals at the Satun General Hospital, PIH, fetal distress and premature labor cases
were successfully delivered in 66.67, 45.46 and 54.54 percent of the cases, respectively, but
the majority of CPD, prolonged stage and breech presentation necessitated caesarean section
(50.00, 45.46 and 90.91% respectively). The following recommendations were made
: the medical and nurse committees, obstetricians and pediatricians should join together
to develop guidelines for the care and referral of patients in labor and the hospitals should
link the data about the results of the care and health status of the mother and child after
referral.
