Outcome of Induction of Labour in a Tertiary Hospital, North Western Nigeria

Background: Induction of labour is a well-known procedure performed to artificially initiate uterine contraction in the interest of the mother, the fetus, or both in order to achieve vaginal delivery. Objectives: The aim of this study is to determine the incidence, indications and outcome of induction of labour in a tertiary health institution in North-West Nigeria. Materials and Method: This is a prospective cross sectional study carried out on the patients undergoing induction of labour in the main labour room of the UDUTH, Sokoto between January, 2016 and December, 2016 Results: During the period of study, there were 3112 deliveries out of which 111 had induction of labour. The incidence of labour induction is therefore 3.6%. The most common indications were postdated/post term pregnancies 51 (46.0%), followed by hypertensive disorders of pregnancy 43(38.7%), and pre-labour rupture of membranes 14(12.6%). Majority of the women 91.0% (101/111) had cervical ripening with Misoprostol, while induction of labour was achieved with Oxytocin infusion combined with artificial rupture of membrane in 71 (64.0%). The mean induction delivery interval was 11.5 (SD 11.6) hours. The study did not demonstrate any statistically significant difference between the methods of IOL and induction delivery interval (n=86, P= 0.531, F=0.638). Majority 78 (70.3%) had spontaneous vaginal delivery, 8 (7.2%) had assisted vaginal delivery, while 25 (22.5%) had emergency Caesarean section. The fifth minute mean Apgar score was 8.1±2.5. The fetal outcome was better among the women who had combination of artificial rupture of membranes (ARM) and oxytocin infusion compared to those who had misoprostol (p-value=005). There were 6 (5.4%)perinatal and one maternal death, thus giving a case fatality rate of 0.9%. The maternal complications observed were primary postpartum haemorrhage 10 (9%) and ante partum haemorrhage 6 (5.4%). Conclusion: The main indications for labour induction in this study were postdated pregnancy and hypertensive diseases. Labour induction was achieved mostly with intravaginal misoprostol and a combination of ARM and oxytocin infusion. Majority of cases resulted in spontaneous vaginal delivery and good fetal outcome.