Abstract
<strong><em>Introduction</em></strong><em>: </em>A new guideline and a strict protocol of oxytocin infusion administered via an infusion pump was adopted for induction of labour (IOL) in the University Obstetric Unit, Teaching Hospital, Mahamodara, Galle, in 2006. <br /> <strong><em>Objective: </em></strong>To describe IOL and its outcome before and after adopting this new guideline and strict protocol of oxytocin infusion at the University Obstetric Unit, Teaching Hospital, Mahamodara, Galle. <strong><em><br />Methods: </em></strong>A prospective descriptive study. Using a pretested form data collected from 322 consecutive women who had IOL during a period of nine months commencing 15th June 2006, were compared with those obtained in the Teaching Hospital, Mahamodara, Galle in 2003 before the new guideline and strict protocol was implemented in the University Obstetric Unit, Galle. <br /> <strong><em>Results: </em></strong>In the University Obstetric Unit the rate of IOL was 8.5% in 2006. The leading indications for IOL were past dates (45.8% in 2003 and 45% in 2006) and pre labour rupture of membranes (28.2% in 2003 and 35.4% in 2006). Successful vaginal deliveries showed a possible increase from 84.7% in 2003 to 90.4% in 2006 and failed inductions showed a possible reduction from 3.8% in 2003 to 2.2% in 2006 ( p = 0.09). The mean induction delivery interval for a successful vaginal delivery was significantly shorter (318 min 95% CI 307 - 327, p < 0.04) in 2006 compared to that of 2003 ( 343 min 95% CI 333 - 370) . The mean dose of oxytocin used for a successful vaginal delivery showed a possible increase from 6.7 units (95% CI 5.8 - 7.4, p = 0.11) in 2003 to 10.4 units (95% CI 6.7 - 16.2 ) in 2006. Mean duration prior to a diagnosis of a failed induction markedly decreased from 932 min (95% CI 790 - 1073) in 2003 to 699 min (95% CI 590 - 809, p= 0.005) in 2006. Mean number of oxytocin units prior to a diagnosis of a failed induction markedly increased from 15 units (95% CI = 15) in 2003 to 25.8 units (95% CI 21-30, p < 0.001) in 2006. Caesarean sections after IOL showed a possible reduction from 15.3% in 2003 to 9.6% in 2006 (p=0.09). There was no significant change in neonatal outcome from 2003 to 2006. <br /> <strong><em>Conclusion: </em></strong>After the adoption of the new guideline and oxytocin infusion protocol in 2006, IOL and its outcome have improved in the University Obstetric Unit, Galle. <strong>Key words</strong>: Induction of labour; labour outcomes. DOI: 10.4038/sljog.v31i2.1753 <em></em> <em>Sri Lanka</em><em> Journal of Obstetrics and Gynaecology</em> 2009; <strong>31</strong>: 97-103
Highlights
A new guideline and a strict protocol of oxytocin infusion administered via an infusion pump was adopted for induction of labour (IOL) in the University Obstetric Unit, Teaching Hospital, Mahamodara, Galle, in 2006
After the adoption of the new guideline and oxytocin infusion protocol in 2006, IOL and its outcome have improved in the University Obstetric Unit, Galle
Successful vaginal deliveries showed a possible increase from 84.7% in 2003 to 90.4% in 2006, and the total caesarean sections after IOL showed a possible reduction for 15% in 2003 to 10% in 2006 (p = 0.09)
Summary
A new guideline and a strict protocol of oxytocin infusion administered via an infusion pump was adopted for induction of labour (IOL) in the University Obstetric Unit, Teaching Hospital, Mahamodara, Galle, in 2006. IOL is indicated if benefits of delivery outweigh the risk of continuing pregnancy. The rate of IOL varies by location, percentage of high risk pregnancies, fetal surveillance facilities available, and unit policies, and appears to be increasing[1]. In the United Kingdom, the rate of IOL ranges from 6 - 25% with the average being about 20%2. In USA the average rate of IOL is approximately 13%3. In a previous study carried out in 2003 at the Teaching Hospital, Mahamodara, Galle, an IOL rate of 11.6% was reported[4]
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