A Study Of Induction Of Labour At Teriary Care Teaching Hospital

Abstract

Background: In this era where safe obstetrics practice to ensure good maternal and fatal outcome is being performed, more and more ways to fore start the labor in unfavourable conditions is being practiced. For such reasons, induction of labor is becoming one of the commonest obstetric procedures nowadays. Over the decades the incidence of induction of labor has raised exponentially. In developed countries the rate being 20-25% while in developing countries the incidence varies around10%3. Induction of labour can be carried out through various methods either surgical/medical methods. Most commonly prostaglandins like PGE1 or PGE2 is used either orally/per vaginally. This study is aimed to analyse the fetomaternal outcome of patients undergoing induction of labour. Material And Methods: A prospective observational study was carried out in the obstetrics and gynaecological department of Smt. SCL general hospital, Smt. NHL Municipal Medical College from November 2021 to April 2022. All the details of the included cases were noted including (obstetric score, details of antenatal period as per the predetermined proforma. All routine investigations were carried out like complete blood count, blood group, ultrasound and covid-19 RTPCR/Rapid antigen test. All the details were tabulated and analyzed. Result: A total of 320 patients were included during the study period at out tertiary care center from November 2021 to April 2022. In our study the majority of the patients belong to the age group of 20-30 years and are gravida 2 or 3 patients showing that maximum parity is in the reproductive age group of the patients. Induction of labor can be carried out by various methods, out of which the above-mentioned methods were taken into consideration. The desirable method for varying maternal situation was taken into consideration following critical analysis of each situation (i.e. Bishop’s score, effective contraction). The delivery induction interval for varying methods of induction of labour has been described in the above table. In our present series it was observed that majority of the patients (40.9%) delivered within 12-24hours of induction. About 31% of patients delivered Ihad a successful vaginal delivery post induction of labor whilst 30% underwent caesarean section owning to various reasons. Out of the 320 patients observed, 22 patients developed complications. Postpartum haemorrhage was observed in 10 of these patients. 13% of the neonates required NICU admission. The main reason for admission was seen to be Meconium aspiration syndrome pertaining to the hyper stimulation caused by induction of labor. Conclusion: Healthy mother with health baby is the ultimate goal to be achieved by any means of delivery. Understanding the physio-pharmacology of labour help clinicians to manage the process more efficiently and modify the process when required, by the use of pharmacological agents to stimulate or initiate labour. Through our study it was observed that induction of labour in necessary conditions helps us in achieving the said goal. Though the risk benefit ratio of induction of labour may exceed in some situations the overall risk ratio of induction of labour remains low. Caesarean section rates also do not increase with induction of labour. [Shah D Natl J Integr Res Med, 2023; 14(2): 16-21, Published on Dated: 15/03/2023]