Success rate of labor induction and it’s determinants at St. Paul’s Hospital Millennium Medical College

Abstract

Summary Introduction Induction of labor refers to the iatrogenic stimulation of uterine contractions before the onset of spontaneous labor to accomplish vaginal delivery. It has potentials for preventing maternal complications and improving pregnancy outcome. The objective of this study is to determine the success rate of labor induction and its determinants in St. Paul’s hospital millennium medical college. Methodology Hospital based cross sectional study was conducted to determine the success rate of labor induction and its determinants at St. Paul’s hospital millennium medical college. Data was collected from July 1, 2016 till Dec. 17, 2016. Women who underwent labor induction in the study period and met the inclusion criteria were included. Data was entered in to SPSS statistical package version 20.0 and analyzed. Univariate and multivariate analysis used to see the association of the dependent and independent variables, P<0.05 considered significant Results- Four hundred two participants were included in the study. Majority 240(59.7%) were nulliparous. The commonest indication for labor induction was pregnancy induced hypertension occurring in 57.7% followed by PROM (20.9%) and oligohydramnios (13.2%). Two Hundred forty-six (61.2%) women had successful induction. One hundred fifty-four (38.3%) of the women who were induced underwent cesarean section. The commonest indication for cesarean section was failed induction 69(44.8%) followed by Non reassuring fetal heart rate pattern 66(42.9%). Mean duration till declaration of failed induction was 11.55hrs and the mean duration of rupture of membrane for those who underwent cesarean section for failed induction (excluding those who came with rupture of membrane) was 5.21±3.43hrs. Multivariate analysis showed multiparty and higher bishop score at the start of labor induction to be a strong predictors of vaginal delivery. Conclusions and Recommendations Cesarean section rate is higher than comparative studies done in western setup. Factors significantly associated with success of induction were multiparity and higher bishop before the initiation of induction. Induction of labor should be made as much as possible after proper cervical ripening and time to declare failed induction should be prolonged. Key words- induction, failed induction