Outcome of Induction of Labor: A Prospective Study

Abstract

Background: Induction is defined as artificial initiation of uterine contraction with the aim of achieving the normal vaginal delivery. It is most widely accepted obstetrical intervention worldwide. The most common indication for induction is post dated pregnancy. Objective: To assess the outcome of induction in both mother and baby. Methods: During our study period, 391 patients were selected for induction due to various indications. Most of them were induced with tablet Misoprostol and only those with higher degree of gravida were induced with Dinoprostone gel intracervically and maternal and fetal outcome was seen.Results: Out of 4020 patients, induction rate was 9.72%. Among them 98.2% were induced with Misoprostol. Most of the induced age group was in between 20-30 years of age with primigravida 62%. Among them 48.59% were in between 40-41 weeks of gestation with 93% of having poor bishops score. About 67.7% had normal vaginal delivery with 4.86%, assisted with instrumental delivery. Cesarean section was seen in 32.3% of patients. Most common indications for LSCS were for failed induction (44%). Regarding the fetal outcome 99.7% born alive, 97.92% went to mother side, 2.07% admitted and 0.51% expired. Beside this, 88.7% had birth weight between 2.5 to 3.5 kg and 87.4% had clear liquor and 99.22% had the good apgar score. Conclusion: Though the cesarean section rate is higher in this study in comparison of WHO references to be not more than 15% but still the induction is beneficial in high-risk pregnancy where continuing the pregnancy is more hazardous than to termination.

A study of effect of oral PGE1 and cervical PGE2 on induction of labor and mode of delivery

“…The Incidence of induction across different settings varies from 5 to 22% of all labor room admissions. [1][2][3] Induced labor is artificial stimulation of uterine contractions before the onset of labor, any time after the fetus attains viability with the main aim to achieve vaginal birth. 4 Pharmacological modes of induction of labor include prostaglandins (per oral or intra-vaginal or intra-cervical) and oxytocin .Successful induction of labor is related to the condition or state of the cervix.…”

“…4 Induction of labor with the help of prostaglandins offer the advantage of promoting cervical ripening along with stimulating the contractility of the myometrium. [1][2][3] The indications for Induction has increased so much in modern obstetrics to avoid the slightest risk to baby or mother that we are electively inducing labor at 39 weeks of pregnancy; though we know that induction is carried out routinely in postdated pregnancies. Many studies have indicated that about 10% of pregnancies remain undelivered beyond 42 weeks, so timely induction remains an important statement to bring out better labor outcomes in both baby and mother.…”

Induction of Labor by Prostaglandin: A Review for Indications and Risk for Cesarean Section

“…The reasons for considering induction are many and vary from obstetrician to obstetrician and from country to country [8]. The most common indication that requires induction of labor is postdated pregnancy [9][10][11][12][13][14][15][16][17][18][19][20][21][22]. Another frequently cited indication is term premature rupture of membrane [12,13,23,24].…”

“…Nevertheless, the hypertensive disorder remains a rare indication, rather this requires induction in higher rate [14,20,21,25,26]. The less frequent indications are oligohydramnios, IUGR, gestational diabetes, fetal distress, macrosomia, fetal death, decreased fetal movement, uncomplicated twins, polyhydramnios, Rh isoimmunization, chorioamnionitis, heart disease, and other fetal indications [9][10][11][12][13][14]. In a meta-analysis, it is also observed that the common indications cited by many researchers are post-term pregnancy, PROM, oligohydramnios, twins, macrosomia, preeclampsia, diabetes, and IUGR [23].…”

“…The outcomes of induction of labor are comparatively better than the spontaneous labor as reviewed from certain studies, while other studies found higher adverse outcomes associated with induction than the spontaneous labor. The causes for failure are mostly failed induction, fetal distress, undiagnosed CPD, meconeum stained liquor, nonprogress of labor, and prolonged latent phase [10][11][12][13]27,28].…”