Maternal outcomes and factors associated with different methods of induction of labour at the University Teaching Hospital - Lusaka, Zambia
Objectives: To determine maternal outcomes and factors associated with different methods of induction of labour, prevalence of and induction to delivery time at the Women and Newborn Hospital of the University Teaching Hospitals in Lusaka, Zambia.
Methods: A cross sectional study design was used with 147 women who met inclusion criteria recruited in the study. Convenience sampling was used to recruite study participants using an investigator admnistered data collection tool. Data analysis was stratified by method of induction of labour. Logistic regression was used to determine association between method of induction and maternal outcome. Association between sociodemographic variables and maternal outcomes were analysed using crude odds ratios to determine statistical significance. Simple logistic regression was then used to further analyse associations with p – values of less than< 0.05
Results: Results showed that in the majority of patients, labour was induced using misoprostol 122 (77.7%) in which most of whom 90 (83%) the vaginal route was used (73.8%) followed by the intracervical balloon catheter. Three (2%) patients suffered uterine hyper stimulation, eight (5.4%) had precipitate labour, one (0.7%) had uterine rupture while three (2%) of the patients had APH and PPH after induction of labour with misoprostol. Regression analysis showed no statistically significant association between uterine hyperstimulation ( p-value 0.503, CI 0.038 – 4.991), Precipitate labour (p value 0.702, CI 0.178 – 12.951), antepartum haemorrhage ( p value 0.999) and post partum haemorrhage ( p value 0.999). There was no association between induction of labour using misoprostol and uterine rupture. There was no statistically significant association between Induction of labour using intracervical ballon catheter and uteine hyperstimulation ( p - value 0.635 CI 0.158 – 20.624), precipitate labour ( pvalue 0.827 CI 0.230 – 6.287), antepartum or post partum haemorrhage. There was no association between induction of labour using intracervical ballon catheter and uterine rupture ( p – value 1.00). Mean induction to delivery time using prostaglandins (misoprostol) was 15.2 hours with a range of 2.9 to 52.4 hours, 21.3 hours with intracervical balloon catheter with a range of 4.0 to 52.4 hours and 20.3 hours for membrane stripping with a range of 19.5 to 20.6 hours.
Conclusion: Induction of labour using either misoprostol or intracervical balloon catheter were not significantly associated with adverse maternal outcomes. There was no association between uterine rupture and induction of labour using either misoprostol or intracervical ballon catheter. The most common method of induction of labour used at the Women and Newborn Hospital involved use of misoprostol followed by the intracervical balloon catheter.
Keywords: Induction of labour, adverse maternal outcomes, associated factors