Vol. 6, Issue 1, Part A (2024)

Background: Induction of labor (IOL) is the artificial initiation of labor before its spontaneous onset, to deliver the fetoplacental unit. IOL is done when the benefit of delivery is more than the continuation of pregnancy. It needs to be differentiated from the failure of progress of labor. There is no evidence to recommend treatment for failed induction, but usually, delivery by cesarean section will be required.
Objective: To evaluate the factors associated with failed induction of labour.
Methodology: A retrospective cross-sectional study was carried out in the Department of Obstertrics & Gyanecology, Shaheed Monsur Ali Medical College Hospital, Dhaka, Bangladesh from January to December 2023. A total of 100 patients attending the labour room of labour induction were included in the study. The inclusion criteria were as follows singleton pregnancy, 37-42 weeks gestation, the absence of active labour, alive fetus with reactive CTG cephalic presentation and no contraindication to vaginal delivery.
Results: 67% (67) patients delivered by caesarean section and 33% (33) by vaginal delivery. The average induction delivery interval was 19 hours. The following factors were associated with increased rate of failed induction: Bishop score <5, Gestational age >41 weeks, Oligohydramnios, Prelabor rupture of membranes, Hypertensive disorders of pregnancy, Induction-delivery interval greater than 24 hours, Absence of dating scan, meconium-stained liquor, small for gestational age and macrosomic babies. All were found to be statistically significant with a p value of less than 0.05. The study also showed that induction of labour is not associated with any major intrapartum and postpartum feto maternal complications.
Conclusion: Most common indication for induction of labour was postdated pregnancy. Other major indications were co morbid fetomaternal conditions which quite seemed to be unavoidable in most cases of failed induction. On other hand case selection for induction of labour is vital for achieving outcomes similar to spontaneous labour.