Comparison of maternal and fetal outcomes between groups of patients undergoing induction of labor and those having spontaneous labor

Abstract

Background and Aim: Pregnancy lasting beyond 40 weeks is a known complication of normal delivery. Various studies have found incidence between 2-14%. Post-dated pregnancy carries specific hazards to both mother and fetus. While mothers are faced with problems like increased incidences of induced labour, instrumental delivery and LSCS with associated morbidities, fetuses are faced with morbidities ranging from IUGR to macrosomia. Present study was with an objective of comparison of maternal and fetal outcomes in patients who went into labor spontaneously with the patients in whom induction of labor was undertaken at a tertiary care government facility in India.Material and Methods: Present study was performed at the department of obstetrics and gynaecology of a tertiary care teaching hospital in India. The participants selected by predefined criteria were divided into 2 groups on the basis of progression of labor. They were spontaneous labor (group A) and induction of labor (group B). All the participants were assessed for various relevant maternal and neonatal outcomes and valid comparisons drawn.Results: In the present study, a total of 1000 participants were finally enrolled as per mentioned selection criteria and considered for analysis; out of which 494 patients were in group A (patients who went into spontaneous labor) whereas 506 patients were in group B (patients where induction of labor was done). The commonest complication noted was postpartum hemorrhage (PPH). The mean duration of labor in group A was 4.62 ±2.12 hours and in group B was 10.01±5.36 hours, significantly higher than in group A. Most common indication for caesarean section was fetal distress (91.1% in group A and 75% group B, p< 0.05). Incidences of NICU admissions and neonatal deaths were significantly higher in induction of labor group.Conclusion: Induction of labor is associated with comparatively more maternal risk of higher induction delivery interval, more cases of caesarean section due to failure of induction as compared with spontaneous labor apart from being associated with neonatal issues like more NICU admissions and fetal deaths in comparison with spontaneous labor.