Introduction: Induction of labor (IOL) is the most common intervention in obstetrics. The objective of this study was to assess the risk factors in term pregnancies and their delivery outcome following IOL. The purpose of the study of risk factors is that it adds more prognostic information to the counselling and planning process of IOL. Method: We conducted this case control study to compare caesarean section (CS) rate among nulliparous women with and without risk factors who were induced with similar labor induction protocol (tablet misoprostol 25 mcg, per vaginally, 4 hours apart, maximum 5 doses). A total of 200 nulliparous women at term with singleton pregnancy, who fulfilled inclusion and exclusion criteria were recruited after taking informed consent. The study was conducted over a period of 1 year in labor ward of obstetrics department of Dr RPGMC Tanda H.P. Result: Our study results demonstrated that maternal age ≥ 35 years, BMI ≥ 25kg/m2, pre-induction bishop score < 5 and hypertensive disorders of pregnancy are significantly associated with CS in patients after IOL. Further logistic regression was performed, to ascertain the effect of variables that were found to be statistically significant on univariate analysis, and on binominal logistic regression also BMI, bishop score and hypertensive disorders of pregnancy were found to have a statistically significant association with CS with AOR of 2.57 (1.24-5.33), 0.19 (0.09-0.39) and 0.28 (0.12-0.68) respectively. Conclusion: The present study emphasizes that both medical and elective IOL is associated with an increased risk of CS predominantly related to unfavourable Bishop score, increases BMI and hypertensive disorders of pregnancy. Patient should be counselled about these risk factors before IOL.
Dr. Mamta Mahajan1*, Dr. Suman Meena2, Dr. Anjali Soni3 (Sun,) studied this question.