Outcome of induction of labour with dinoprostone at a teaching hospital in Nepal
Keywords:Delivery, Dinoprostone, Induction, Labour, Neonates, Outcome
Background: Induction of labour has now become a common practice; this study was conducted to find the outcome of induction of labour in pregnant women in relation to: induction delivery interval, mode of delivery, maternal complications and fetal outcome.
Methods: It was a hospital based prospective study conducted from April 2012 to March 2013. Singleton pregnancy of gestational age ≥37 weeks, with vertex presentation and Bishops Score <6 were the cases included for induction. Dinoprostone (0.5mg) intracervically was used for induction. The different outcome parameters were analyzed.
Results: Of 100 cases enrolled, majority 93% were below 30 years, mean gestational age of induction was 40.7± 0.7weeks and 58% were primi gravida. Ante natal care visit of ≥3 was present only in 66%. At induction 55% had bishop score of (0-3) and rest had score of (4-5). Postdated pregnancy (67%) followed by hypertension (13%) were the two most common causes for induction. 58% required second dose of dinoprostone, and the induction delivery interval was 24.3±9.6 hrs. 63% of the induced labour progress for vaginal delivery. Fetal distress (56.4%) was the commonest indication for caesarean section (CS). 6% of the cases had postpartum hemorrhage. 13% of the delivered neonate required NICU care, of which 53.8% was moderately asphyxiated. There was no maternal or neonatal death.
Conclusions: In pregnancy undergoing induction of labour, CS is not uncommon, and there are few chances of maternal and neonatal morbidities. Therefore, obstetrician should be vigilant to avoid any untoward events.
Dutta DC. Induction of labour. Text book of obstetrics. 7th ed. Kolkota (India): New central Book Agency (P) Ltd; 2010:522-31.
Cunnigham FG, Leveno KJ, Bloom SL, Hauth JC, Rouse DJ, Spong CY. Labour induction, Williams Obstetrics. 23rd ed. McGraw Hill; 2010:500-10.
Gupta N, Mishra SL, Jain S.A randomized clinical trial comparing Misoprostol and Dinoprostone for cervical ripening and labour induction. J Obstet Gynecol India. 2006;62(2):149-51.
Tenore JL. Methods for cervical ripening and induction of labour. Am Fam Physician. 2003;67(48):2123-8.
Castanteda C.S.Misoprostol dose selection in a controlled-release vaginal insert for induction of labor in nulliparous women. Am J Obstet Gynecol. 2005;193:1071-5.
Agrawal P. Cervical ripening and induction of lobour. Obstet Gynecol. 2003;3:113-5.
Bukola F, Idi N, M’Mimunya M, Jean-Jose WM, Kidza M, Isilda N et al. Unmet need for induction of labor in Africa: secondary analysis from the 2004 - 2005 WHO global maternal and perinatal health survey (a cross-sectional survey). BMC Public Health. 2012 Aug 31 ;12:722.
Park KH, Hong JS, Shin DM, Kang WS. Prediction of failed labor induction in parous women at term: role of previous obstretic history, digital examination and sonographic measurement of cervical length. J Obstet Gynaecol Res. 2009;35(2):301-6.
Mukherjee K, Neogi U, Gangooli G, Mishra R, Verma M, Dayal M et al. A comparative study of induction of labour by prostagladin E2 and oxytocin and its outcome. J Obstet Gynaecol India. 1996;46:631-5.
Jarvelin MR, Hartikainen-Sorri AL, Rantakallio P. Labour induction policy in hospital of different levels of specialisation. Br J Obstet Gynaecol. 1993;100:310-5.
Misra M, Vavre S. Labour induction with intra-cervical prostagladin gel and intravenous oxytocin in women with a very unfavourable cervix. Australia New Zealand J Obstet Gynaecol. 1994;34:511-5.
Xenakis EMJ, Piper JM, Conway DL, Longer O. Induction of labor in the nineties: Conquering the unfavourable cervix. Obstet Gynaecol. 1997;90(2)235-9.
Macer JA, Macer CL, Chan LS. Elective induction versus spontaneous labour: A retrospective study of complications and outcome. Am J Obstet Gynaecol. 1992;166(6):1690-7.