Predictors of successful induction of labour at a tertiary obstetric service in Southwest Nigeria
Context: Induction of labour is a useful obstetric intervention, yet it is underutilized in Africa. Recommendations for practice may reduce its unmet need.
Objective: This study aims to determine labour induction success rates and identify predictors of outcome.
Study Design, Setting and Patients: This was a retrospective, descriptive, cross‑sectional study of 104 women who had induction of labour at the University College Hospital, Nigeria.
Main Outcome Measures: Primary outcomes were vaginal delivery within 24 hours and caesarean delivery. Analyses were done by Chi‑square tests, t‑tests and logistic regression.
Results: Labour induction rate was 12.7%; most were performed on account of post‑dated pregnancies and pre‑labour rupture of membranes. Forty‑six, (44.2%) had vaginal delivery within 24 hours whereas induction failed (i.e. caesarean delivery) in 38 (36.5%). The mean duration of the process was 12.0 ± 6.6 hours with misoprostol, 8 hours less than with oxytocin (P < 0.01). Misoprostol was significantly more likely to result in delivery within 24 hours in comparison to extra‑amniotic transcervical catheter for ripening (P = 0.02, OR = 5.1, 95% CI = 1.2–21.1), and to oxytocin for induction (P = 0.03, OR = 6.5, 95% CI = 1.2–36.3), respectively. Adverse effects were infrequent and comparable with either method.
Conclusion: Success rate needs to be improved upon. Higher parity, later gestation and misoprostol ripening or induction are associated with successful outcomes. It is recommended that clients’ experience may be improved by commencing misoprostol cervical ripening the night before induction and administering the medication orally rather than vaginally.
Keywords: Induction of labour; intervention; outcome; predictor of success
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