Analysis of preterm induction of labour

Abstract

Introduction: Preterm labor is defined as regular uterine contractions occurring at least once every 10 minutes and resulting in cervical dilatation or effacement before 37 weeks' gestation. A preterm infant is any infant delivered before 37 weeks' gestation. Material and Methods: This is a prospective study conducted at Department of Obstetrics and Gynaecology, Subbaiah Institute of Medical Sciences, over a period of 1 year. All patients admitted in antenatal ward and labour room requiring preterm induction were included in this study. Pregnancies with major fetal anomalies or no intrapartum fetal monitoring were excluded. All patients were monitored in labour room with auscultation and non-stress test (NST). Mifepristone was given orally and Prostaglandin E2 (PGE2) gel was inserted in posterior fornix. Results: There was a total of 70 deliveries during this period. The preterm induction majorly includes 20-34 years as this is the commonest reproductive age group seen in our hospital. Multigravida requires induction more as compared to primigravida. More number of patients were induced between 32-36 weeks, reason being Preterm premature rupture of the membranes (PPROM), severe preeclampsia, intrauterine device (IUD) and severe Fetal growth restriction (FGR). 33% of the cases being induced due to PPROM, Fetal demise being the second cause of induction in our analysis. It is also interesting to note that HCC also contributes to be one of the causes of induction. 62.8% were induced via PGE2 gel. Out of 70 patients 87.1% of them delivered vaginally, 9 underwent lower segment Caesarean section (LSCS) i/v/o fetal distress and another one i/v/o Prolonged PROM. Conclusion:Our findings suggest that vaginal delivery is likely following preterm induction of labor (IOL) irrespective of gestational age. Parity and cervical favorability are the first and second strongest predictors of a successful vaginal delivery, respectively. Labor curves accelerate with each category of GA, ultimately approximating those observed following term IOL.