Induction of labour: indications and obstetric outcomes in a tertiary referral hospital.

AIMS

To examine the indications for induction of labour at a tertiary referral hospital and compare operative delivery rates between women in spontaneous labour and those being induced.

METHODS

Prospective case series over three months. Information obtained from questionnaires, chart reviews and computer delivery summaries.

RESULTS

The overall induction rate was 23%. After 25 exclusions, 438 inductions were studied: 239 by questionnaire and 199 by chart review. Five percent of all inductions were primarily for maternal request or social reasons. Twenty-three percent were for ACHS/RACOG non-defined indications. From the questionnaires, 21% of women induced had requested induction. Spontaneous delivery rates were significantly reduced for induced women, compared with those labouring spontaneously (61.0% versus 72.1%, p<0.001). The Caesarean section rate was significantly increased with induced labour (21.5% versus 14.9%, p<0.001), the increased rate occurring in nulliparae (27.7% versus 19.1%, p=0.008) rather than multiparae (15.1% versus 11.7%, p=0.19). Surgical delivery rates were similar for women induced for defined and non defined indications.

CONCLUSIONS

Regardless of the indications for doing so, induction of labour is associated with significantly reduced spontaneous delivery rates overall and an increased Caesarean section rate in nulliparae.