Abstract
BackgroundInduction of labor is an artificial initiation of uterine contractions after fetal viability with the aim of vaginal delivery prior to the onset of spontaneous labor. Prevalence of induction of labor is increasing worldwide with subsequent increase in failure rate. However, there is limited evidence on labor induction in Ethiopia. Therefore, this study was aimed at assessing the prevalence and associated factors of failed induction of labor among women undergoing induction of labor at referral hospitals of Amhara national regional state, Ethiopia, 2016.MethodA multicenter cross-sectional study was conducted at referral hospitals found in Amhara national regional state from February 01 to September 30, 2016. Multistage sampling technique was employed to select a total of 484 women who underwent labor induction. Pre-tested structured questionnaires and checklists were used to collect the data. Data were entered into EPI info version 7 and analyzed using SPSS version 20 software. Stepwise Binary Logistic regression model was fitted to identify factors associated with failed induction of labor. The level of significance was determined based on the adjusted odds ratio with 95% confidence interval at the p-value of ≤0.05.ResultThe prevalence of failed induction of labor among women undergoing induction of labor was 31.4% (95% CI: 27.0, 36.0). Failed induction of labor was independently predicted by a Bishop score of ≤5 (AOR = 2.1; 95% CI: 1.3, 3.6), prolonged latent first stage of labor (AOR = 2.0; 95% CI: 1.2, 3.5), induction with oxytocin alone (AOR = 4.2; 95% CI: 2.2, 8.1), nulliparity (ARO = 1.9; 95% CI: 1.2, 2.9), post term pregnancy (AOR = 4.1; 95% CI: 1.8, 9.3) and hypertensive disorder of pregnancy (AOR = 2.4; 95% CI: 1.5, 5.1).ConclusionFailed induction of labor was high in the study area compared to the reports of previous studies done in Ethiopia. The majority of the determinants of failed induction of labor were connected with unjustifiable and inconsistent indication of induction of labor. Thus, preparing standardized practical guidelines and preventing unjustifiable case selection may help reduce the current high failure rates.
Highlights
Induction of labor is an artificial initiation of uterine contractions after fetal viability with the aim of vaginal delivery prior to the onset of spontaneous labor
Failed induction of labor was high in the study area compared to the reports of previous studies done in Ethiopia
This study shows that the prevalence of failed Induction of labor (IOL) in the study settings was 31.4%, which is in line with a World Health Organization (WHO) study report in eight Latin American countries − 30% [23] and a result which was reported at Kathmandu Medical College - 34.6% [24]
Summary
Induction of labor is an artificial initiation of uterine contractions after fetal viability with the aim of vaginal delivery prior to the onset of spontaneous labor. The Ethiopian government is working towards improving maternal and neonatal health and establishing measures to ensure that no mother dies in the process of giving birth [2]. In this regard, effective obstetric management is crucial, and obstetric management efforts need to be rigorous so as to overcome the incidence of poor outcomes. Induction of labor (IOL) is the artificial initiation of uterine contractions after the period of viability with the intention of accomplishing vaginal delivery prior to onset of spontaneous labor [4]. A definition of failed IOL that coincides with mode of delivery seems the best option since it evaluates the accomplishment of the purpose of induction [7]
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