Use of low dose misoprostol for induction of labour in a secondary hospital setting: a retrospective cohort study of a unique induction protocol
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20231536Keywords:
Induction of labour, Misoprostol, Low resource settingAbstract
Background: Induction of labour is a procedure often used in pregnant women where there are clear medical indications. There are various modalities of induction of labour which differ in outcomes and complications. Our aim was to look at how effective our protocol using misoprostol was in achieving delivery within 24 hours of the start of induction, the induction delivery interval, Caesarean section rates and its indications using Robsons classification, uterine hyperstimulation with FHR changes and oxytocin augmentation and its duration.
Methods: This was a retrospective study which looked at the mode of induction and outcomes of women during the period from 1st February, 2021 to 31st July,2021.
Results: There were 2574 deliveries in the period February 1st, 2021 to July 31st, 2021. We found more nulliparous women and obese women in the induced group. The main indication for induction was past dates and the mean induction to delivery interval among the women being induced was 32 hours (SD: 22.58). There were significantly higher women who experienced PPH and Caesarean sections were 2.100 (1.577- 2.793) times higher among women who were induced.
Conclusions: Induction protocols need to be developed taking into consideration the advantages as well as complications associated with it and then tailor it according to infrastructure and personnel available.
References
WHO recommendations: Induction of labour at or beyond term. Available at: https://www.who.int/publications-detail-redirect/9789241550413. Accessed on 14th April 202.
Sanchez-Ramos L. Induction of Labor. Obstet Gynecol Clin North Am. 2005;32(2):181-200.
Middleton P, Shepherd E, Crowther CA. Induction of labour for improving birth outcomes for women at or beyond term. Cochrane Database Syst Rev. 2018;5:CD004945.
Mozurkewich E, Chilimigras J, Koepke E, Keeton K, King V. Indications for induction of labour: a best-evidence review. BJOG Int J Obstet Gynaecol. 2009;116(5):626-36.
Lydon-Rochelle MT, Cárdenas V, Nelson JC, Holt VL, Gardella C, Easterling TR. Induction of Labor in the Absence of Standard Medical Indications: Incidence and Correlates. Med Care. 2007;45(6):505-12.
de Vaan MD, Ten Eikelder ML, Jozwiak M, Palmer KR, Davies-Tuck M, Bloemenkamp KW, et al. Mechanical methods for induction of labour. Cochrane Database Syst Rev. 2019;10:CD001233. .
Kerr RS, Kumar N, Williams MJ, Cuthbert A, Aflaifel N, Haas DM, et al. Low‐dose oral misoprostol for induction of labour. Cochrane Database Syst Rev 2021;(6).
Zhang X, Kramer M. The rise in singleton preterm births in the USA: the impact of labour induction. BJOG Int J Obstet Gynaecol. 2012;119(11):1309-15.
Nippita TA, Trevena JA, Patterson JA, Ford JB, Morris JM, Roberts CL. Variation in hospital rates of induction of labour: a population-based record linkage study. BMJ Open. 2015;5(9):e008755.
Guerra G, Cecatti J, Souza J, Faúndes A, Morais S, Gülmezoglu A, et al. Factors and outcomes associated with the induction of labour in Latin America. BJOG Int J Obstet Gynaecol. 2009;116(13):1762-72.
Vogel JP, Souza JP, Gülmezoglu AM. Patterns and outcomes of induction of labour in africa and asia: a secondary analysis of the WHO Global Survey on Maternal and Neonatal Health. PLOS ONE. 2013;8(6):e65612.
Alfirevic Z, Aflaifel N, Weeks A. Oral misoprostol for induction of labour. Cochrane Database Syst Rev. 2014;(6).
Hofmeyr GJ, Gulmezoglu AM, Alfirevic Z. Misoprostol for induction of labour: a systematic review. BJOG Int J Obstet Gynaecol. 1999;106(8):798-803.
