Rabia Sajjad, Ayesha Snover, Nazia Sajjad, Ambreen Anwar.
Induction at poor bishop is justified!.
Isra Med J Jan ;6(1):6-8.

OBJECTIVES: To prove that induction at poor bishop is not justified. STUDY DESIGN: A Prospective study. PLACE AND DURATION: Obstetrics and Gynecology Department of Military Hospital Rawalpindi from September 2011 to Feb 2012. METHODOLOGY: Total of 1852 women were included by non-probability consecutive sampling technique, irrespective of parity at term with singleton healthy pregnancy in vertex presentation and were divided into two groups on basis of their bishop score. Health volunteers, cases of uterine rupture, previous cesareans, uncontrolled medical disorder and pregnancy with fetal anomaly for termination were excluded. Ultrasound for fetal wellbeing were done and strict feto maternal monitoring was done during labor. Medical and elective indications and Bishop Scores were recorded before labor induction. Cervical foley no 16 was used in patients with B/S >3. (Group – A) and tablet Prostin E2 was used in patients with B/S< 3 (Group – B) as an initial agent to induce labor. Outcomes like mode of delivery, mean parity and mean age was analyzed by spss11 and P value was found out Performas were attached with patient's case notes. RESULTS: The cesarean section rate was 32.6% (n=605), SVD were (n=1247). Induction for medical reasons were 14.8% (n=275), with PROM 12.7% (n=237), women with fetal compromise were 11.7% (n=218), with macrosomia 9.07% (n=24), with mild pains 15.3% (n=285), with postdate pregnancy 16.4% (n=340), post term 18.4% (n=305) and patients with oligohydramnios were 1.2% (n=168). Among 1852 from 38 week to 41 week, 1372 patients in group A, with bishop score >3. Rest of 480 were in group B, induced at bishop score <3. In group A, who were induced at B/S >3, total CS were 215, (150 with failed trial of labour) and 1157 were SVD. 65 CS were due to fetal distress. Total CS in group B, with failed trial were 300, C-Section due to fetal distress n=90. SVD were 90 and p=0.001. Mean age was 33.8 years. Mean parity found to be was 2.8 para. Difference in no of CS and SVD in both groups on basis of their bishop score was statically significant and was = 0.001. CONCLUSION: Bishop Score at time of induction should be >3 and induction at poor bishop should be avoided to control the rate of cesarean section.

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