Gulfreen Jalil, Rehana M Malik.
Induction of Labor - An audit of indications and obstetrical outcome in a tertiary care hospital.
Pak Postgrad Med J Jan ;14(3):116-20.

OBJECTIVE: To examine the indications of induction of labor 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 prospective analysis of 100 patients with Bishop score of <= 6 admitted for induction of labour, done with 3 mg Prostaglandin E2 pessary (Dinoprostone Prostin E2), followed by amniotomy and / or oxytocin infusion. A comparison of indications and outcomes was made among nullipara and multipara. Data was analyzed by x2 and Student`s t 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 = 0.001 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 no 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.

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