Utjecaj majčinih i fetalnih faktora na uspješnost medikamentozne indukcije poroda

Abstract

Labour induction is the process in which labour is induced mechanically or pharmacologically. The percentage of induced labours is between 1.4% and 32% of the total number of births in the world. The aim of this research is to present the number of medically induced labours from 2012 to 2019 at the Clinic for Gynaecology and Obstetrics of the Clinical Hospital Center in Osijek and to present the success rate of medically induced labour and factors, both maternal and/or foetal which may affect it. Materials and methods: In the study 2361 subjects were included whose births were induced by medication regardless of the indication for medically induced labour, gestational age or mother’s age. χ2 test, Mann Whitney U test, Fisher’s exact test, Kruskal Wallis test (Pot Hoc Conover), and the univariate and multivariate logistic regression model were used. Results: The percentage of inductions was 13.8%. 81% of the child births was completed vaginally , while 19% was completed by the caesarean section. The univariate regression analysis found that meconium amniotic fluid increases the risk of the caesarean section after the labour has been induced. Factors decreasing the possibility of the caesarean section after induced labour include multiparity, women age between 25 and 35 years and women bearing female children. The multivariate statistical regression model found that women over the age of 36 are 1.58 times more likely to have the caesarean section. Women with meconium amniotic fluid are 1.47 times more likely to have the caesarean section. Multiparity in the mother and the female sex of the child reduce the probability of the caesarean section after induced labour (odds ratio (OR) 0.20, P=0.02 and OR 0.84, P=0.09, respectively). Conclusion: The study indicates that multiparity and female gender of child increase the probability of the vaginal birth after the induction, while the mother’s age over 36 and meconium amniotic fluid after the induction increase the risk of the caesarean section.