Study of the risk factors for cesarean delivery in induced labor at term

Abstract

Introduction: Induction of labor has become one of the most common intervention in obstetrics. Induction of labor is a common and essential element of the contemporary obstetric practice and now account for approximately 20% of all deliveries (NICE 2008). Induction of labor (IOL) is often the principal medical intervention utilized to decrease both maternal and neonatal morbidity and mortality. Aim: To identify those factors which influence the risk of emergency cesarean delivery in induced labor at term. Materials and Methods: A total of 100 admitted women with a live singleton live fetus in cephalic presentation and induced at term (≥37 weeks) in labor room of MCSG, SMS Medical College, Jaipur. Cases were women who delivered by emergency cesarean section and controls were women with a vaginal delivery among the cohort. Observations:The study shows that pregnant women with advanced maternal age (age>35yrs, p value=0.0008), BMI>35kg/m3 (p value=0.0001), poor preinduction BISHOP SCORE (p value=0.0001) and nulliparity (p value=0.0001) was significantly associated with failed induction. Conclusion:There are several clinical elements that need to be considered to estimate the success of induction and minimize the risk of emergency c/s. factors increasing the likelihood of failed induction were advanced maternal age≥35years, maternal BMI ≥30kg/m 2 , nulliparity, poor preinduction bishop score<5. So if induction fails, an emergency caesarean delivery has to be performed, and maternal and fetal morbidity are greater in emergency C/S than those in elective C/S.