Abstract:
Background: Induction of labor refers to techniques for stimulating uterine contractions to
accomplish delivery prior to the onset of spontaneous labor. It is common obstetric procedure
primarily employed when the benefits of delivery outweigh the risks of continuing the pregnancy.
Higher rates of induction of labor may also contribute to lowering caesarean section rates without
increasing other adverse pregnancy outcome. Minimizing caesarean section rates without
increasing other adverse pregnancy outcomes is a priority consideration in low income countries
where available resources need to be judiciously utilized
Elective induction of labor refers to the initiation of labor for convenience in an individual with a
term pregnancy that is free of medical or obstetrical indications.
Objective: To Identify Determinants of failed Induction of labor among induced pregnant
mothers at Mettu Karl Hospital 2018.
Methods: Institutional based case control study was conducted among 270 induced mothers.
From which 90 cases (failed induction) and 180 controls(successful induction) were selected by
consecutive sampling technique in which the data was collected by structured questionnaire and
analyzed by SPSS v. 21 to identify frequency distributions, mean with standard Deviation and
multivariate logistic regressionwhich wasused to identify Determinants of failed induction. A 95
%confidence interval and 5% level of precision was utilized to declare presence of association
between dependent and independent variables in final model.
Result: For a total of 90 cases and 180 controls, Hypertensive disorders of pregnancy was the
most common cause of induction in both case (35%) and control (46.7%) groups. post term
pregnancy is the second common cause of induction for cases (27.8%) whereas premature rupture
of membranes (31.7%) was for controls. Out of 90 cases and 180 controls 75.6% of controls and
83.3% of cases had an unfavorable bishop score. Most of the women 89.4% and 95.6% of
controls and cases respectively were induced by oxytocin. During induction process, cervical
ripening was done in 72.8 % of controls and in 81.1% of cases with different techniques, of which
majority, 66.7 % and 74.4% was with misoprostol for controls and cases respectively. More than
half 65.6% of cases and 57.8% of controls were primigravida. Bishop score, AOR=16.813(1.526-
185.226), Gestational age, AOR=15.190 (6.487-35.570) and Duration of labor AOR=15.190
(6.487-35.570) had been shown to be the main predictor of Failed induction. Conclusion and recommendation; The study revealed that BishopScore, Gestational age and
Duration of labor had association with failed induction and it recommended to assess the cervical
status (using the Bishop score) before induction was commenced and the hospital should have
quality assurance programs and induction policies to ensure that inductions are performed in the
best possible quality.
