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Abstract
IntroductionFailed induction increased maternal morbidity and mortality due to the associated complication which comes with cesarean section such as post partum hemorrhage and sepsis. The reports of previous articles on the proportion and associated factor of failed induction were variable and inconsistent. Therefore, this meta-analysis found out that the pooled proportion of failed induction and its associated factors in Ethiopia. MethodsSystematic search was done by online databases (Pub Med, Web of Science, Google scholar and HINARI, and Ethiopian universities digital libraries). Unpublished studies that are found in the Ethiopian universities’ digital libraries were used for this systematic review and meta-analysis study. Data were entered into Microsoft Excel and then exported to STATA 11 version statistical software for analysis. Heterogeneity assessed using the I2 statistic. The pooled proportion of failed induction and the odds ratio (OR) with a 95% confidence interval was showed using forest plots. ResultThe overall proportion of failed induction was 23.58 % (95% CI: 13.72–33.44). Unfavorable Bishop Score [OR = 4.45, 95CI:2.44,8.12 ] intermediate Bishop Score [OR = 8.87, 95CI:4.62,17.05 ] and being primiparous woman [OR = 3.04, 95CI:1.74,5.53 ] were factors associated with failed induction of labour. ConclusionThe prevalence of failed induction was high in Ethiopia. Unfavorable Bishop Score, intermediate Bishop Score, and primiparous were significantly associated with failed induction. Proper pelvis assessment for Bishop Score will be considered prior to initiating the induction of labor. Beside to this, the health professionals shall be aware of the relevance of cervical ripening for intermediate and unfavorable Bishop Score for pregnant women's before induction of labor.
Highlights
Failed induction increased maternal morbidity and mortality due to the associated complication which comes with cesarean section such as post partum hemorrhage and sepsis
The sub-group analysis showed that the prevalence of failed induction among women who had induction slightly varies across regions
The present study showed that having unfavorable Bishop Score were 4.54 times more likely to got failed induction as compared to those who had a favorable Bishop Score
Summary
Failed induction increased maternal morbidity and mortality due to the associated complication which comes with cesarean section such as post partum hemorrhage and sepsis. The reports of previous articles on the proportion and associated factor of failed induction were variable and inconsistent. Unfavorable Bishop Score [OR 1⁄4 4.45, 95CI:2.44,8.12 ] intermediate Bishop Score [OR 1⁄4 8.87, 95CI:4.62,17.05 ] and being primiparous woman [OR 1⁄4 3.04, 95CI:1.74,5.53 ] were factors associated with failed induction of labour. Unfavorable Bishop Score, intermediate Bishop Score, and primiparous were significantly associated with failed induction. Proper pelvis assessment for Bishop Score will be considered prior to initiating the induction of labor. The health professionals shall be aware of the relevance of cervical ripening for intermediate and unfavorable Bishop Score for pregnant women's before induction of labor. Induction is commencement of uterine contractions by using uterotonic drugs prior to the onset of spontaneous labor with or without ruptured membranes [1]. Failed induction is unable to get adequate uterine contraction and poor cervical changes after 6–8 h of oxytocin administration with the use of maximum dose and drops for at least one hour [5]
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