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Labour and Delivery Posters
Induction of labour: are we doing the right thing at the right time?
  1. A Nakash2,
  2. AA Eissa1,2,
  3. H Zaheen2,
  4. F Chowdary2,
  5. M Zakaria2
  1. 1University College London, London, United Kingdom
  2. 2Royal Free Hospital, London, United Kingdom

Abstract

Twenty percent of labours in the UK are induced.1 However; induction of labour (IOL) involves increased obstetric risk, and should be used judicially.

Objectives We audited IOL at a London Teaching Hospital, to assess the incidence, adherence to the guidelines in terms of indications and timing, obstetric outcomes, and looked for any association between the outcome, the parity, and the gestational age (GA).2 3

Methods A retrospective audit included 440 women over the period from January to September 2010 inclusive.

Results The incidence of IOL was 20%. Indications were:- prolonged pregnancy (61%), Diabetes and GDM (12%), and hypertensive disorders (5%). In 6% the indications did not comply with guidelines e.g. presumed large baby, and in 5% the indications were not documented.

The National and London Caesarean Section rate is 24%, (our hospital rate is 30%). IOL accounted for14% of the overall C/S rate. Ninety per cent (90%) were induced within the recommended GA. No maternal or perinatal deaths occurred; although one woman sustained bowel injury during C/S.

Conclusion The indications and the timings of IOL were within the guidelines. Thirty seven per cent (37%) of primiparous patients were delivered by emergency C/S, compared to 6% of those who were multiparous.

We recommend adherence to NICE guidelines in selection, and in offering membrane sweep to facilitate IOL in prolonged pregnancies.

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