Fetomaternal Outcome in Medically Indicated Induction of Labour at Term Gestation QC21-QC24
Dr. Nivedita Jha,
Assistant Professor, Department of Obstetrics and Gynaecology, Pondicherry Institute of Medical Sciences,
Introduction: The medical induction of labour at term gestation has always been controversial and is based on conflicting evidences.
Aim: To determine the fetomaternal outcome of medical induction of labour at term gestation.
Materials and Methods: It was a retrospective observational study and manual and electronic data were retrieved from a tertiary care centre of Southern India. All women after 37th week of gestation with single live fetus in cephalic presentation with a Bishop score <6 and a reactive non-stress test having medical indications were induced with medical method. The primary outcome measures included number of women who went into spontaneous labour, incidence of failed induction, induction delivery interval and modes of delivery.
Results: A total of 602 patients were included in this study. The mean age, gravida and parity were 25.24Â±4, 1.4Â±0.6 and 1.45Â±0.84 respectively. Oligohydramnios was the commonest indication 174(28.9%) for labour induction, followed by diabetes 119(19.8%) and Premature Rupture Of Membrane (PROM) at term 77(12. 8%). Normal vaginal delivery was achieved in 406 (67.4%) of women. LSCS (lower segment caesarean section) was performed in 140(23.3%) of patients, while 56(9.3%) patient required instrumentation. The incidence of LSCS in oligohydramnios, gestational hypertension and diabetes was 40(23%), 16(23.1%) and 26 (21.8%) respectively. Furthermore, the fetomaternal outcomes were similar irrespective of gravidity and gestational age.
Conclusion: Medical methods of induction are safe and reliable and also do not increase the risk of foetal and maternal complications. Induction of labour for medical indication in term pregnancy does not increase the risk of caesarean delivery and adverse foetal and neonatal outcomes.