DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20212968

Current practice of induction of labour and maternal outcome in ≥37 week of gestation: an observational study

Jil Manishkumar Sheth, Anjani Shrivastava, Kedar Trivedi

Abstract


Background: As we know induction is done when benefit to mother and fetus overweigh benefits of continuing the pregnancy. According to NICE guidelines, induction of labor leads to 15% of instrumental deliveries and 22% of total LSCS. In new civil hospital, Surat (according to 2017) failure of induction of labor was 2nd most common indication of LSCS. The objective of this study were to analyse labor induction with respect to indication for induction of labor and its maternal outcome so that we optimize our protocol of labor and reduce our LSCS rates for the same, can reduce feto-maternal morbidities also.

Methods: This was prospective observational descriptive study carried out over duration of 6 month. 200 consecutive cases of consenting women requiring induction of labour and fulfilling inclusion criteria were selected. Induction was done with prostaglandin analogous. Data were collected includes age, parity, gestational age, bishop score, indication of induction, and maternal outcome. And data was analyzed by using EMI software.

Results: Timely induction of labor can reduce maternal morbidity and ensure the delivery of a healthy baby. Among 200 consenting women 58.5% were multigravida and 41.5% were primigravida. Most common indication of induction among study participants is prolong rupture of membrane which is 35.5%. Among them 71.4% had vaginal delivery having poor bishop score. Most common indication for LSCS were fetal distress (34.8%).

Conclusions: We concluded that elective induction of labor was associated with lower rates of LSCS and improved maternal and neonatal outcome.


Keywords


Induction, Bishop score, Maternal outcome

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References


Cunningham FG, Leveno KJ, Bloom SL, Dashe JS, Barbara L. Williams obstetrics. 24th ed. New York, NY: McGraw Hill; 2014.

Leduc D, Biringer A, Lee L, Dy J, Clinical Practice Obstetrics Committee; Special Contributors. Induction of labour. J Obstet Gynaecol Can. 2013;35(9):840-57.

Macer JA, Macer CL, Chan LS. Elective induction versus spontaneous labor: a retrospective study of complications and outcome. Am J Obstet Gynecol. 1992;166(6):1690-6.

McKinney E, Ashweil J, Murray S, James S, Gorrie T, Drokse S. Maternal Child Nursing. Philadelphia: WB Saunders: 2000.

Cunningham FG, Leveno KJ, Bloom SL, Dashe JS, Barbara L. Williams obstetrics. 25th ed. New York, NY: McGraw Hill; 2018.

Taipale P, Hiilesmaa V. Predicting delivery date by ultrasound and last menstrual period in early gestation. Obstet Gynecol. 2001;97(2):189-94.

Barr WB, Pecci CC. Last menstrual period versus ultrasound for pregnancy dating. Int J Gynaecol Obstet. 2004;87(1):38-9.

Hamm RF, Downes KL, Srinivas SK, Levine LD. Using the Probability of Cesarean from a Validated Cesarean Prediction Calculator to Predict Labor Length and Morbidity. Am J Perinatol. 2019;36(6):561-6.

Grobman W. A randomized trial of elective induction of labor at 39 weeks compared with expectant management of low-risk nulliparous women. Am J Obstet Gynecol. 2018;218(1):601.

Middleton P, Shepherd E, Flenady V, McBain RD, Crowther CA. Planned early versus expectant management (waiting) for prelabor rupture of membranes at term (37 weeks or more). Cochrane Database of Syst Rev.2017;4(1):5302.

The Royal Australian and New Zealand College of Obstetricians and Gynecologists, Excellence in Women’s Health. Term Prelabour Rupture of Membranes (Term PROM). 2017.

Koopmans CM, Bijlenga D, Groen H, Vijgen SM, Aarnoudse JG, Bekedam DJ, et al. Induction of labour versus expectant monitoring for gestational hypertension or mild pre-eclampsia after 36 weeks' gestation (HYPITAT): a multicentre, open-label randomised controlled trial. Lancet. 2009;374(9694):979-88.

Wang Y, Hao M, Sampson S, Xia J. Elective delivery versus expectant management for pre-eclampsia: a meta-analysis of RCTs. Arch Gynecol Obstet. 2017;295(3):607-22.

Spiegel E, Weiner Z, Shlomo I, Shalev E. For how long should oxytocin be continued during induction of labour?. BJOG. 2004;111(4):331-4.

Ngoc NT, Merialdi M, Aleem H, Carroli G, Purwar M, Zavaleta N, et al. Causes of stillbirths and early neonatal deaths: data from 7993 pregnancies in six developing countries. Bull World Health Organ. 2006;84(9):699-705.

Fernand A. Prolong Pregnancy: Practical guide to high risk pregnancy and delivery. 4th ed. India: Elsevier; 1997: 150-152.

Decency A, Nathan L, Laufer N, Roman AS. Current Obstetrics and Gynecology- Diagnosis and treatment. 10th ed. New York, NY: McGraw Hill; 2007; 281.