INTRODUCTION:
Around 10 - 50% of all deliveries are preceded by labour induction, a proportion that has not varied dramatically over recent years. Fetal death was the only indication for labour induction centuries ago, while this is now a very rare indication, with prolonged pregnancy and maternal hypertensive disorders being the major indications for the last 50–60 years. Safety, success, and patient satisfaction continue to be the major objectives with economic evaluations now becoming a significant factor in the search for the ideal induction method. TURNBULL (1970) said that the spontaneous labour is robust and effective
mechanism and should be allowed to operate on own. we should induce labour if we are sure we can do better. Induction of labor is defined as the initiation of the process of labour, by artificial methods to anticipate delivery via naturalis after the fetus has attained the viability. AIM OF THE STUDY:
1. To study the profile of induced labour in a tertiary care institution. 2. Outcome of such induction in NULLIPARA & MULTIPARA. 3. Intrapartum, Postpartum maternal and neonatal morbidity and mortality of patients who underwent induction of labour. MATERIALS AND METHODS: This study was conducted at Institute of Obstetrics and Gynaecology, Chennai. Approval of institutional ethical committee had been obtained.
TYPE OF STUDY: Prospective observational study.
PERIOD OF STUDY: JANUARY 2008 TO JUNE 2008.
METHODOLOGY:
Inclusion Criteria: Singleton live Pregnancies, Cephalic Presentation, Gestational Age >37 Weeks, Bishop Score <4, Reactive CTG, No Spontaneous uterine contraction, Exclusion criteria: Multiple Pregnancies, Mal presentation, Preterm Pregnancies, Non Reactive CTG, Antepartum haemorrhage, Previous uterine scar, Spontaneous Labour. Reason for Induction: 1. Absolute Indication - As in severe PET, imminent eclampsia, eclampsia. 2. Marginal indication - GDM on insulin, PET, Repeated false labour, AFI < 8, BOH, Hospital protocol as in postdated pregnancy, Rh negative pregnancy and prelabour rupture of membranes. Patients were counseled regarding the decision taken and their wishes respected. Informed written consent obtained. SUMMARY: Mean age of women 23.3with range between 18 and 37 years.
Mean gestational age is 41 weeks. Nulliparous women accounted for 74.25%. About 52% of primipara and 47.5% of multi has associated antepartum risk factor. Medical disorders, mainly PET (23.41%) formed the major antenatal risk factor. Most common indication for induction is postdatism followed by
Preeclampsia. Rate of vaginal delivery is 51.1% .Among them 65.6% delivered with single dose of PGE2 and augmentation with oxytocin. 8.59% delivered with two doses of PGE2and augmentation with
oxytocin. Rate of caesarean section is 48.3%. Common indication for induction is fetal distress.
Mean birth weight is 2.89 with range between 1.5 and 4.0kg. No uterine rupture was encountered in the study. CONCLUSION: The rate of induction of labour has increased nowadays with better methods for
induction of labour and better techniques for evaluation of fetal wellbeing available.
Clearly the favorability of the cervix has a substantial impact on the potential success of
any labour induction. The present study thus shows that application of intracervical
PGE2 gel caused favourable changes in the cervix by increasing the Bishop score with
minimal side effects. Although labour induction is not without its risks for the mother
and particularly for the fetus, intracervical PGE2 gel application followed by oxytocin is
found to be safe and acceptable method for induction of labour in patients with
unfavourable cervix with minimal maternal morbidity and mortality
