Perinatal outcome of induced labour.

Abstract

SummaryFrom 1st January 1982 to 31st March 1983, 1057 consecutive cases of induced labour were studied in the University Unit, Kandang Kerbau Hospital, Singapore. The rate of induction was 9.8% and the method was artificial rupture of membranes and oxytocin titration. 559 (52.9%) were primigravidae and 498 (47.1%) were multigravidae. The leading indications were static weight or weight loss at term 356 cases (33.6%), pre‐eclampsia 240 cases (22.7%), and prolonged pregnancy 100 cases (9.5%).129 (12.3%) had amniotic fluid abnormalities at artificial rupture of membranes. 944 (89.3%) were monitored by cardio‐tocography during labour. 12.1% had suspicious fetal heart rate traces and 8.1% abnormal traces. Fetal blood sampling was used in 3% of monitored cases. There was no incidence of cord prolapse intrauterine infection, or of placental abruption.There were no intrapartum deaths and three early neonatal deaths, one of which had unsuspected lethal congenital malformations. Fifty neonates (4.7%) were admitted to the special care baby unit (SCBU), thirteen (1.2%) having required intubation. In a control group of spontaneous labours 4.6% of low risk and 8.5% of high risk normally formed neonates over 2500 grams birth weight were admitted to the SCBU. The mean Apgar score in the study group was 8.6 at 1 minute and 9.8 at 5 minutes.The emergency caesarean section rate in induced labour was 16.5% compared with 6.1% in spontaneous labour. Failed induction of labour was the indication in 42.0% of cases followed by fetal distress in 33.3% of cases.Whilst the perinatal outcome of induced labour was good, the caesarean section rate was high especially in primigravidae. More objective analysis of the degree of fetal compromise before induction of labour should reduce the induction rate and the caesarean section rate without detriment to perinatal outcome.