Determinants of Failed Induction of Labor Among Induced Term and Post Term Pregnant Mothers In Attat Catholic Hospital, Gurage Zone, SNNPRS And Mettu Karl Hospital, Oromia Regional State, South West, Ethiopia: A Case Control Study

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.