Outcome of Surgical Induction of Labourin a Combined Military Hospital

Ismat Ara,Mn Sakhawat Hassain,Rokshana Sultana,Sm Solaiman

doi:10.3329/bmrcb.v44i1.36805

Ismat Ara, Mn Sakhawat Hassain + Show 2 more

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https://doi.org/10.3329/bmrcb.v44i1.36805

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Abstract

Induction of labour is considered justified when the benefits of prompt delivery outweigh the consequences of Caeserian Section (CS). Literature on the effectiveness and safety of surgical induction of labour in term and postdated pregnancy is limited in Bangladesh. This study was aimed to assess the effectiveness and safety of surgical induction of labour in term and postdated pregnancy.This prospective clinical study was conducted in the in-patient Department of Obstetrics and Gynecology, Combined Military Hospital (CMH), Dhaka from July, 2005 to June 2006. A total of 100 pregnant women with term and postdated pregnancy were selected for the study by simple random sampling. The particulars of the patient, detailed menstrual and obstetric history, induction delivery interval, mode of delivery and foetal outcome and maternal complications were recorded. The results were analysed by Statistical Package for Social Science (SPSS) version 16.0.The mean±SD age of the participants was 25.79±6.16 years with a range of 18-38 years. The indication of Induction of labour included term pregnancy (79%) and postdated pregnancy (21%).Normal vaginal delivery was done in 78% cases, CS in 17% cases and vacuum extraction in 5% cases.Ninety three percent babies were born healthy, 6% were asphyxiated, perinatal death 2% and still born 1%. O2 inhalation was needed for 6% babies. Prolonged second stage (7%), post-partum haemorrhage (8%), maternal distress during labour (10%) and manual removal of placenta (12%) were the observed maternal complications.No significant difference was observed between term and post term pregnancy in the term of normal vaginal delivery, vacuum extraction and lower uterine cesarean section.Induction of labour is beneficial for both term and postdated pregnancy with associated complications. Foetal outcome was good and maternal complications were acceptable.Bangladesh Med Res Counc Bull 2018; 44(1):52-58

Highlights

Induction of labour (IOL) is the stimulation of regular uterine contraction before the spontaneous onset of labour using mechanical or pharmacological methods in order to generate progressive cervical dilatation and subsequent delivery.[1]
This variability is the result of differences in the obstetric protocols or the judgment of the individual physician regarding the appropriateness of obstetric interventions.[5]
The World Health Organization (WHO) Global Survey on Maternal and Perinatal Health, conducted in 24 countries which included nearly 3,00,000 observations, showed that 9.6% of them were delivered by labour induction

Summary

Introduction

Induction of labour (IOL) is the stimulation of regular uterine contraction before the spontaneous onset of labour using mechanical or pharmacological methods in order to generate progressive cervical dilatation and subsequent delivery.[1] For induction of labour, the benefits of early delivery to either mother or fetus should outweigh the risks of pregnancy continuation.[2] The incidence of labour induction has continued to rise over the past several decades.[3] The rate of labour induction varies from 9.5-33.7% of all pregnancies annually.4Labour induction rates present a wide country variation and present among obstetric units in the same geographic region or practitioners within the same hospital.

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