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. Objective: : To Assess Determinants of failed Induction of labor among induced term and post
term pregnant mothers in Attat Hospital and Mettu Karl hospital, Ethiopia. Methods: Institutional based case control study was conducted among 270 induced mothers. A
total of 270 induced mothers in both Hospitals; [n Attat primary hospital 60 cases(failed
induction) and 120 controls (successful induction) and in Mettu Karl hospital 30 cases(failed
induction) and 60 controls (successful induction) were taken by using consecutive sampling
method 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 (46.7%) and control (35%) 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. Unfavorable Bishop score, AOR=16.813(1.526-185.226),intermediate Bishop score AOR 24.781(2.335-263.047) 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 Duration of labor, unfavorable and intermediate Bishop score 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.
