Abstract

ASSOCIATION OF INDUCTION OF LABOR WITH FETOMATERNAL OUTCOME

*Dr. Sheeba Hussain, Dr. Urooj Malik, Dr. Summaya Pathan and Dr. Habiba Sharaf

ABSTRACT

Introduction: Induction of labor is a method that is used worldwide to improve the neonatal outcome when continuation of pregnancy poses potential risks to mother or baby. Judicious use of induction of labor is associated with a reduction in maternal and neonatal mortality. However there is fear among the obstetric team regarding the safety of the induction itself for the mother and baby. Objective: we therefore conducted this study with the aim of assessing thefetomaternal outcome in induction of labor. Materials and Methods: We conducted ahospital based prospective observational study at the department of obstetrics and gynecology Zia Uddin Hospital Karachi, from 1ST July 2017 -30TH June 2018.Women with live singleton pregnancy of more than or equal to 37 weeks gestation with cephalic presentation and no clinical evidence of cephalopelvic disproportion and no history of previous uterine surgery who had indication for induction of labor were recruited. Women were induced with misoprostol, intracervical Foley’s catheter. Fetomaternal outcome, mode of delivery and induction to delivery interval in hours was noted. Results: The mean induction to delivery interval was11.4 hours. 171 patients (57%) delivered within 12 hours. 129 patients (43%) delivered at between 12 -24 hours. Overall vaginal delivery was achieved in 256 (85.33%) patients. 251 (83.67%) hadspontaneous vertex deliver, 7(2.33%) had vaccum vaginal delivery while 44(14.67%) patients underwent emergencycesarean section. Meconium staining of liquor was found in 6.67% (20) of our cases, abnormal CTG in 0.3 %(1) while 6.3% (19) had both abnormal CTG as well as meconium staining of liquor. Apgar scores were more than 7 in 92.4% neonates, while it was less than 5 in 3.3 % patients None of our study subjects had uterine hyper stimulation or uterine rupture. There was no induction related intrauterine death in our study. Conclusion: Intracervical Foley’s as well as misoprostol are safe and effective methods of labor induction in third trimester.

Keywords: labor, induction, misoprostol, maternal hyper stimulation, fetal distress.