Predictors of successful induction of labour in post-term pregnancies at the Kenyatta National Hospital, Nairobi
Background: A prolonged pregnancy poses a threat to the fetal survival in-utero and may compromise
perinatal outcomes. Worldwide 5-10% of all pregnancies are prolonged, and post-datism remains the commonest indication for induction of labour.
Objective: To determine predictors of successful induction of labour in post-term pregnancies at Kenyatta National Hospital (KNH).
Methods: A prospective observational study among post-term pregnant women delivering at KNH.
Results: The success rate of induction among study participants was 68%. Prostaglandins in combination with artificial rupture of membranes and oxytocin infusion were the commonest used methods for inducing labour. Multiparity was major predictor for successful induction of labour; 55% in primigravidae; between 84% (OR 4.4[95% CI 2.0-9.6]) and 87% (OR 5.3[95% CI 1.1-24.7]) in multiparous. Another significant predictor of successful induction of labour was the pre-induction Bishop’s score; 85.2% (OR 3.8[95% CI 1.6- 8.6]) of patients with Bishop score above 6 compared to 60.4% of patients with lower scores. The odds of a successful induction were also significantly lower in newborns weighing above 4000 grams (OR = 0.02, 95% CI 0.003-0.21) compared to those weighing less than 4000 grams.
Conclusion: A favourable Bishop’s score, multi-parity and birthweight were better predictors of successful induction of labour in post term pregnancies at the KNH.
Keywords: Post-term pregnancy, Prolonged pregnancy, Induction of labour, Successful induction of labour
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