Induction of Labour an Audit of Indications and Obstetrical Outcome in a Tertiary Care Hospital

Abstract

Objective: To examine the indications of induction of labour at Services Hospital Lahore, a tertiary) care hospital and to study the maternal and fetal outcomes of this obstetrical intervention. Study design:: This study involved a retrospective analysis of 100 patients with Bishop score Of ≤ 6, admitted for induction of labour, done with Prostaglandin E₂ , pessary (Dinoprostone 3mg), followed by amniotomy and / or oxytocin infusion. A comparison of indications and outcomes was made among nullipara and multipara. Data was analyzed by X²â€™ and Student’s / test. Results: The induction rate was 8% and the commonest indication was hypertensive disorders of pregnancy 42%, followed by prolonged pregnancy 22% and pre- labour  rupture of membranes 21% . The mean induction to delivery interval was 21.2 hours for nullipara and 15. 1 hours  for parous   women,    p   =  0.00 was   statistically   significant.   The caesarean delivery rate was  higher   with   induced   labours  in nullipara 52% than in multipara 22%, the difference was statistically significant. 21% babies born with induced labours had Apgar score ≤ 4 and 8% required admission in neonatal intensive care unit. 17% patients had postnatal or post-operative complications. There were perinatal or maternal losses. Conclusion: It was concluded from  the  study  that  labour induction results in increased risk of operative delivery and longer hospital stay. Therefore,  all  obstetrical  units should monitor the frequency of labour  induction,  scrutinize  the  indications  and  assess  the  impact  of  induction  to  determine  the effect on caesarean delivery rate and perinatal  outcome.