Determinants of outcome of Induction of Labor in Four Teaching Hospitals in Addis Ababa, Ethiopia
INTRODUCTION: Induction of labor is an increasingly common intervention in obstetrics and known to decrease maternal and perinatal mortalities; therefore, it is necessary to determine the safety and effectiveness of our institutions’ cervical ripening methods and labor induction process.
METHODS: A cross sectional prospective quantitative study was done. Data was collected from a sample of 339 induction cases that were selected consecutively during the study period. Data were collected from medical records of cases using a structured questionnaire Data were analyzed using SPSS. Study was approved by the Institutional Review Board of Addis Ababa University.
RESULT: The rate of failed induction was 25.4%. The rate of Cesarean Section was 37.8%. Failed induction contributed to 66.7% of indications for Cesarean section among the induced labors. Direct oxytocin was used in 39.2%, vaginal misoprostol in 27.7%, PGE2 in 23.6% and Foley Catheter in only 9.4%. There is significant association between failed induction and unfavorable Bishop Score, indication for induction, gestational age and nulliparity, all having a P<.01. There was no association between failed induction and method used with maternal and fetal outcomes. A favorable Bishop Score was achieved in only 20% of cases.
CONCLUSION: Failed induction and associated cesarean section rate is high in our setup compared with global rates. Therefore, reviewing our institutions’ induction guideline in an attempt to increase the success of vaginal delivery is important.
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