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Induction of labour – what influences outcomes?
  1. SA Tirlapur,
  2. A Batish,
  3. W Zhang,
  4. R James,
  5. A Nakash,
  6. A Wright
  1. Royal Free Hospital, London, UK

Abstract

Objectives To identify predictors of vaginal delivery following induction of labour.

Method A retrospective review of 200 consecutive case notes from women induced in a London teaching hospital over 13 months, between January 2009 to January 2010.

Results 9% of women had a documented body mass index (BMI) greater than 30 at booking. 58% had a vaginal delivery (spontaneous or assisted). 5% of women being induced were aged over 40% and 50% had a vaginal delivery.

61% of the patient population were Caucasian, of whom 70% had a vaginal delivery. 19% were Asian and 56% of them delivered vaginally compared to 46% of the African population.

60% of primigravidae patients delivered vaginally compared to 85% of mutiparous patients.

16% were induced for hypertension, 40% for postmaturity, 9% for prolonged rupture of membranes and 15% for gestational diabetes, all achieving similar vaginal delivery rates. 43% of the diabetic patients were Asian.

88% required induction with prostaglandins, 9% by artificial rupture of membranes and 3% with syntocinon augmentation following spontaneous rupture of membranes.

40% of patients had a spontaneous vaginal delivery and 24% had an instrumental delivery. 36% of women had an emergency Caesarean, 15% for fetal distress, 13% for failure to progress and 8% for failure to enter established labour.

Conclusion These data suggest that Caucasian ethnicity and multiparity were positive predictors for vaginal delivery, while BMI, indication for induction and maternal age over 40 did not influence mode of delivery.

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