Beliefs and practices in using misoprostol for induction of labour among obstetricians in Zimbabwe

Abstract

Background . Misoprostol is commonly used for induction of labour in term pregnancy. There are different routes and dosing schedules for administering the drug. Objectives . To describe the prescribing pattern (dose, route, duration), beliefs and factors affecting use of misoprostol for inducing term pregnancy among practising obstetricians in Zimbabwe. Methods . A cross-sectional descriptive survey was undertaken among practising obstetricians in Zimbabwe. A questionnaire was sent as an email, WhatsApp or short message service (SMS, or text) web link to all practising obstetricians in Zimbabwe using the SurveyMonkey online tool. All consenting practitioners were requested to respond online. The responses were analysed using the SurveyMonkey software. Results . There were 52 responses from the 63 questionnaires, a response rate of 82.5%. Seventy-six percent preferred oral misoprostol for induction of labour. The most common indication for induction was prolonged pregnancy accounting for 58% of respondents. The largest group of the practitioners who responded (36%) learnt their misoprostol dosing regimen from WHO/FIGO/NICE guidelines. A composite of highly variable dose regimens referred to as ‘other regimens’ was the dosing regimen preferred by 34% of respondents. Fiftyeight percent of practitioners used two cycles of misoprostol dosing before concluding that induction had failed and 52% would resort to caesarean section immediately if induction failed. Conclusion. The results show marked heterogeneity in the dosing schedules employed by obstetricians for induction of labour with the majority not following standard misoprostol guidelines for labour induction.