Abstract
Objectives: A prospective study was conducted in the department of obstetrics & Gynaecology, Kamla Nehru State Hospital for mother and child, Indira Gandhi Medical College, Shimla from 1st july 2010 to 30th april 2011 on 150 pregnant women. The aim was to evaluate the clinical and ultrasonic feto-maternal parameters which can predict the success of induction of labour.Methods: Gestational age, maternal height, weight, BMI, Bishop score, investigations including ultrasound, transabdominal scan to assess the fetal biometric parameters (BPD,HC,AC and FL), EFW, AFI & fetal head position and transvaginal scan to measure cervical length and cervical funnelling in all recruited subjects before initiating induction of labour (IOL) was done. After delivery, the women were allotted to one of the following groups: Group 1: women having caesarean delivery for non-progress of labour and failed induction of labour (non successful IOL group), Group 2: women having normal vaginal delivery (successful IOL group). Their clinical and ultrasonic parameters were compared.Results: Out of 150 pregnant women, 32 underwent caesarean delivery (21.33%).The t-test was used for quantitative data and Pearson Chi square or fishers exact test was used for categorical databases. The four variables which can significantly predict the failure of IOL in the present study were nulliparity, Bishop score of < 3, Occipito-Posterior fetal head position on TAS and Birth weight 2.5 Kg.Conclusion: Clinical parameters nulliparity, Bishop score < 3, birth weight ? 2.5 kgs and ultrasonic parameter i.e. Occipito-Posterior fetal head position are the 4 most significant parameters to predict the failure of IOL. Out of these parameters, the three best predictors were parity, birth weight and fetal head position. This can be useful in pre-induction counseling.
Highlights
Passage through the birth canal is the shortest but probably the most hazardous journey made by any individual in his or her life
The consequences of labour induction should always be considered carefully. These include the possibility of failed labour induction leading to caesarean delivery and for the fetus, iatrogenic prematurity[1]
Bishop score, fetal head position on TAS and birth weight have been found to be best predictors defining the risk of caesarean delivery in pregnant population undergoing induction of labour (IOL)
Summary
Passage through the birth canal is the shortest but probably the most hazardous journey made by any individual in his or her life. The risks are increased if they are associated with preterm and post-term birth, prelabour rupture of membranes or antepartum haemorrhage and when labour is induced as a consequence of medical or obstetric disorders of pregnancy. 20% end up with emergency caesarean delivery[2]. Labour induction was started in view of benefits of delivery to the mother or fetus outweighing the potential risks of continuing the pregnancy[1]. The consequences of labour induction should always be considered carefully. For the mother, these include the possibility of failed labour induction leading to caesarean delivery (the risk is approximately increased two fold compared with spontaneous labour) and for the fetus, iatrogenic prematurity[1]
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