An observational study on indications and outcomes of induction of labour in tertiary maternity unit

Authors

  • G. Mohanapriya Department of Obstetrics and Gynecology, ACS Medical College and Hospital, Chennai, Tamil Nadu, India
  • G. Ganitha Department of Obstetrics and Gynecology, ACS Medical College and Hospital, Chennai, Tamil Nadu, India
  • Jikki Kalaiselvi Department of Obstetrics and Gynecology, ACS Medical College and Hospital, Chennai, Tamil Nadu, India
  • Vijayalakshmi Gnanasekaran Department of Obstetrics and Gynecology, ACS Medical College and Hospital, Chennai, Tamil Nadu, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20261069

Keywords:

Induction of labour, Caesarean section, Pregnancy, Premature rupture of membranes, Prostaglandins

Abstract

Background: Induction of labour (IOL) is the artificial initiation of uterine contractions when continuation of pregnancy may increase maternal or fetal risk. Common indications include post-term pregnancy, premature rupture of membranes (PROM), hypertensive disorders of pregnancy, oligohydramnios, and suspected fetal compromise. This study aimed to evaluate the indications for IOL and to assess associated maternal and neonatal outcomes in a tertiary maternity unit.

Methods: This prospective observational study included 172 term women (37-41 weeks) undergoing IOL at ACS Medical College, Chennai, over 8 months, from January to June 2025. Patients with spontaneous labour or prior caesarean were excluded. Maternal demographics, indications, induction methods, labour course, delivery mode, and maternal and neonatal outcomes were recorded.

Results: The mean maternal age was 27.8±4.2 years, with 61.6% nulliparous, 99.4% booked, and 0.6% unbooked cases. The main indications for IOL were post-term pregnancy (26.7%), PROM (22.1%), hypertensive disorders (14%), oligohydramnios (10.5%), and foetal compromise/IUGR (5.8%). Misoprostol/PGE₂ gel was used in 60.5%, Foley balloon±oxytocin in 17.4%, and ARM±oxytocin in 22.1% of cases. Spontaneous vaginal delivery occurred in 58.7%, operative vaginal delivery in 4.7%, and caesarean section in 36.6%. Indication for LSCS was primarily due to failed induction (46%) or foetal distress (28.6%). Maternal complications included PPH (9.3%) and hyperstimulation (4.1%). Neonatal outcomes included a mean birth weight 3010±420 g, Apgar <7 at 1 min in 8.1%, NICU admission 12.8%, and perinatal mortality 1.2%.

Conclusions: IOL in this tertiary unit effectively achieved vaginal delivery in most women. Post-term pregnancy, PROM, and hypertensive disorders were common indications. Prostaglandins were mainly used, with minor maternal and neonatal complications.

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References

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(5):CD004945. DOI: https://doi.org/10.1002/14651858.CD004945.pub4

Vecchioli E, Cordier A-G, Chantry A, Benachi A, Monier I. Maternal and neonatal outcomes associated with induction of labor after one previous caesarean delivery: A French retrospective study. PLoS One. 2020;15(8):e0237132. DOI: https://doi.org/10.1371/journal.pone.0237132

Dahlen HG, Thornton C, Downe S, de Jonge A, Seijmonsbergen-Schermers A, Tracy S, et al. Intrapartum interventions and outcomes for women and children following induction of labour at term in uncomplicated pregnancies: a 16-year population-based linked data study. BMJ Open. 2021;11(6):e047040. DOI: https://doi.org/10.1136/bmjopen-2020-047040

Grivell RM, Reilly AJ, Oakey H, Chan A, Dodd JM. Maternal and neonatal outcomes following induction of labor: a cohort study: Outcomes following induction of labor. Acta Obstet Gynecol Scand. 2012;91(2):198-203. DOI: https://doi.org/10.1111/j.1600-0412.2011.01298.x

Kjerulff KH, Attanasio LB, Edmonds JK, Kozhimannil KB, Repke JT. Labor induction and caesarean delivery: A prospective cohort study of first births in Pennsylvania, USA. Birth. 2017;44(3):252-61. DOI: https://doi.org/10.1111/birt.12286

Bengtsson F, Ekéus C, Hagelroth A, Ahlsson F. Neonatal outcomes of elective labor induction in low-risk term pregnancies. Sci Rep. 2023;13(1):15830. DOI: https://doi.org/10.1038/s41598-023-42413-6

Grobman WA, Rice MM, Reddy UM, Tita ATN, Silver RM, Mallett G, et al. Labor induction versus expectant management in low-risk nulliparous women. N Engl J Med. 2018;379(6):513-23. DOI: https://doi.org/10.1056/NEJMoa1800566

Hong J, Atkinson J, Roddy Mitchell A, Tong S, Walker SP, Middleton A, et al. Comparison of maternal labor-related complications and neonatal outcomes following elective induction of labor at 39 weeks of gestation vs expectant management: A systematic review and meta-analysis. JAMA Netw Open. 2023;6(5):e2313162. DOI: https://doi.org/10.1001/jamanetworkopen.2023.13162

Tanwar M, Choudhary A, Mishra S. Analysis of labor induction in a tertiary care hospital. Int J Reprod Contracept Obstet Gynecol. 2020;9(11):4627. DOI: https://doi.org/10.18203/2320-1770.ijrcog20204823

Alayu S, Talie A, Bishaw KA. Vaginal delivery following induction and associated factors among laboring women at South Wollo Zone Public Hospitals of Ethiopia, 2023. Sci Rep. 2024;14(1):25255. DOI: https://doi.org/10.1038/s41598-024-74589-w

Thangarajah F, Scheufen P, Kirn V, Mallmann P. Induction of labour in late and post-term pregnancies and its impact on maternal and neonatal outcome. Thieme. 2016;76(7):793-8. DOI: https://doi.org/10.1055/s-0042-107672

Soni K, Subudhi K, Misra B, Gouda BC, Chaudhary S. Maternal and perinatal outcome in induction of labour: A comparative study. Sch J App Med Sci. 2017;5(1D):273-81.

Sharma S, Sharma R, Gautam A. Analysis of indications of induction of labor and feto-maternal outcome in a tertiary care hospital. Int J Res Med Sci. 2023;11(8):2885-8. DOI: https://doi.org/10.18203/2320-6012.ijrms20232417

Jaiswal S, Kyejo W, Kilewo C. Maternal and neonatal outcome in pregnant women undergone induction of labor at Muhimbili National Hospital, Dar Es Salaam, Tanzania. BMC Springer. 2024;24(1):387. DOI: https://doi.org/10.1186/s12884-024-06578-w

Chuwa S, Chiduo M, Sylvester B. Fetal-maternal outcomes of induction of labour among women delivered at regional referral hospitals in Dar es Salaam Tanzania. Afr J Appl Res. 2022;8(2):240-7. DOI: https://doi.org/10.26437/ajar.31.10.2022.16

Sinha M, Arya SB, Saxena S, Sood N. Induction of labour and its feto-maternal outcome. Int J Reprod Contracept Obstet Gynecol. 2019;8(7):2748. DOI: https://doi.org/10.18203/2320-1770.ijrcog20193037

Poornima JK, Vijayalakshmi, C. A, Famida, Latha S. Evaluation of induction of labour in a tertiary care hospital. Int J Reprod Contracept Obstet Gynecol. 2020;9(4):1361. DOI: https://doi.org/10.18203/2320-1770.ijrcog20201055

Babu S, Manjeera LM. Elective induction versus spontaneous labor at term: prospective study of outcome and complications. Int J Reprod Contracept Obstet Gynecol. 2017;6(11):4899. DOI: https://doi.org/10.18203/2320-1770.ijrcog20174997

Nour SA, Shalaby NS, Wafa ZF. Outcomes of Labor in Women Undergoing Induction of Labor and Plan of Nursing Action. Port Said Sci J Nursing. 2017;4:2. DOI: https://doi.org/10.21608/pssjn.2017.33072

Sheth JM, Shrivastava A, Trivedi K. Current practice of induction of labour and maternal outcome in ≥37 week of gestation: an observational study. Int J Reprod Contracept Obstet Gynecol. 2021;10(8):3132. DOI: https://doi.org/10.18203/2320-1770.ijrcog20212968

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Published

2026-04-07

How to Cite

Mohanapriya, G., Ganitha, G., Kalaiselvi, J., & Gnanasekaran, V. (2026). An observational study on indications and outcomes of induction of labour in tertiary maternity unit. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. https://doi.org/10.18203/2320-1770.ijrcog20261069

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Original Research Articles