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Obstetric Outcome and Significance of Labour Induction in a Health Resource Poor Setting

DOI: 10.1155/2014/419621

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Abstract:

Objectives. The aim of this study was to evaluate the methods, indications, outcome of induced labor and its significance in obstetric practice in the study area. Methods. This was a retrospective study of cases of induced labor at the Catholic Maternity Hospital in Ogoja, Cross-River State, Nigeria, between January 1, 2002, and December 31, 2011. Data on the sociodemographic characteristics of the parturient, induction methods, indications for induction, outcomes and reasons for failed induction were abstracted from personal case files and the hospital’s maternity/delivery register. The data were analyzed with SPSS15.0 window version. Result. The induction rate in this study was 11.5%. Induction was successful in 75.9% of cases but failed in 24.1%. Misoprostol was the commonest induction method (78.2%). The commonest indication for induction was postdate pregnancy (45.8%). Failed induction was due to fetal distress, prolonged labor, cephalopelvic disproportion and cord prolapse. The induction-delivery interval was ?hours. Conclusion. Induction of labor is a common obstetric procedure which is safe and beneficial in well-selected and properly monitored high risk pregnancies where the benefits of early delivery outweigh the risk of continuing the pregnancy. 1. Introduction Induction of labor is the artificial initiation of labor before its spontaneous onset for the purpose of achieving vaginal delivery of the fetoplacental unit [1, 2]. It is a common obstetric procedure which is indicated when the benefits to the mother or fetus outweigh the benefits of continuing the pregnancy [1, 2]. It can involve a complex set of interventions that may defy routines and presents numerous choices and challenges for clinicians and mothers. The rate of induction of labor varies by location and institution but appears to be increasing [1]. In Nigeria a rate of 6.6% was reported in Maiduguri [3]. According to the most current studies in the United States, the rate varies from 9.5 to 33.7 percent of all pregnancies annually [2] One of the most common indication for labor inductions is postterm pregnancy and induction for this indication has been shown to reduce the likelihood of perinatal death [4, 5]. Other indications for induction include premature rupture of membranes especially at term or other situations that require termination of conservative management of high risk pregnancies, potential fetal compromise such as significant fetal growth restriction, nonreassuring fetal surveillance, maternal medical conditions like diabetes, renal disease, significant pulmonary

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