International Journal of Advances In Case Reports

FETAL OUTCOME FOLLOWING INDUCTION OF LABOUR AT A SPECIALIST HOSPITAL, KADUNA, NIGERIA

Ojabo AO*1, Adesiyun AG2, Audu O3, Ameh N2, Hajaratu Umar2

austinojabo@yahoo.co.uk

Induction of labour, Hypertensive disorders, Bishop Score, Multiparity, Foetal distress, Caesarean section, Ruptured uterus, Oxytocin.

One hundred and fifteen cases of induced labour between January 2006 and December 2009 were studied at the Garkuwa Specialist hospital, Kaduna, Kaduna State, Nigeria. The age of the patients ranged from 16 to 43 years with mean age of 26. 26 (+4.08) years. There were 61(51.5%) primiparae and 54(48.5%) multiparae in the series. Hypertensive disorders accounted for 37.39% of all indications for induction; followed by prolonged pregnancy (20%) and premature rupture of the membranes (16.52%). The most popular method of induction was by cervical ripening with intracervical Prostin-E2 insertion prior to synchronous fore water amniotomy and intravenous oxytoxin infusion accounting for 84.3% of cases. Eighty-five (73.9%) of the patients delivered vaginally while 30 (26.08%) ended in an emergency caesarean section. Forty-five (83.3%) of multiparae had vaginal delivery and 9 (16.7%) had caesarean section while 40 (65.7%) of primiparae were successfully induced and 24 of them (34.3%) had caesarean section. In 36 patients with lower Bishop scores (i.e.<6), vaginal deliveries occurred in 20 (44.5%) while 16 (44.44%) had caesarean section. Contrarily, out of 79 cases with higher Bishop scores (i.e. > 6), 67 (84.8%) had vaginal deliveries and o15.2% had caesarean section. The mean induction delivery interval (IDI) for lower (i.e. 4-6), intermediate (7-9) and higher Bishop scores (10-12) were 10.2 + 3.13 hours, 8.65 + 0.69 hours and 3.93 + 1.17 hours, respectively. The commonest indication for caesarean section was foetal distress (33%) followed by inefficient uterine action and cervical dystocia (20%). With the exclusion of intrauterine foetal death as an indication, there was no recorded case of perinatal or maternal mortality in the series.