To ascertain any differences in fetomaternal outcomes in induced and spontaneous labour among multiparous women delivering at term without an identified indication for induction.

Abstract

Background : To ascertain any differences in fetomaternal outcomes in induced and spontaneous labour among multiparous women delivering at term without an identified indication for induction. Methods : This was a prospective study of 212 women with spontaneous labour and 104 women with induced labour who were delivered at 37 weeks to 40+6 weeks gestation, all without identified medical and obstetrical indications for induction. Results : Initial Bishop score in the induced group was low (?5) in 58.7% compared to 40.6% in spontaneous group (p=0.002). Mean duration of total labour (8.8+4.4vs 7.58+4.4hours), first stage of labour (8.26+2.4vs 7.02+1.3hours) was significantly short in induced group as compared to spontaneous group (p 0.001). Caesarean section rate was found to be insignificantly higher in induced group (18.3%) compared to (16.5% in) spontaneous group (p=0.69). Instrumental delivery rate was also higher in induced group (10.6%) as compared to spontaneous group (8.5%) but statistically insignificant (p=0.54), no difference was found regards second and third stage, duration of rupture of membranes, vaginal lacerations, 1 minute and 5 minute apgar scores, admission to NICU and hospital stay. Conclusions : Multiipara who have spontaneous onset of labour the initial mean Bishop score is more compared to the subjects who have induced labour. The study did not demonstrate an increase in rate of caesarean section when Bishop score was ?5 (p=0.97). Compared to those with spontaneous labour, multiparas with induced labour are more likely to have short duration of labour specially the first stage but the mode of delivery is not affected.