The Use of Misoprostol for the Induction of Labour in a Private General Hospital in Ghana

Abstract

Introduction: Misoprostol has been successfully used for the induction of labour especially in patients with an unripe cervix. Few studies done in Africa to document its use have been done in teaching hospitals in Nigeria, Ghana and South Africa. This study wastherefore undertaken to assess the use of Misoprostol in a typical private primary care hospital setting in Ghana.Methods: Delivery records of one hundred and thirty three (133) consecutive women admitted to the Maternity unit for induction of labour for medical or obstetric reasons, who successfully delivered vaginally, were reviewed and data extracted from patient records for univariate analysis.Results: The mean maternal age was 29.18 years (SD: 4.83) with 46.6% of them being nullipara. Gestational age at induction was between 38 to 41 weeks. The insertion of Misoprostol-to-delivery time lasted for a mean of 13.80 (SD 7.85) hours with a range of 1.67 to40.75. 50.4% delivered with perineal injury and a majority of these (65.67%) occurred in the nulliparous patients. The mean Apgar score at 1 minute was 7.02 [SD 2.52] whilst that for 5 minutes was 8.31[SD 2.79]. The difference was however statistically significant (p < 0.000).Conclusion: Due to the high incidence of perineal injury in nulliparous patients in this study (65.67%), there should be an evaluation of the delivery techniques of the midwives in the hospital especially on using timely episiotomies to reduce these injuries. Misoprostol induction is however recommended for use in primary care.