Background In developed countries up to 25% of labours are induced.1 Induction of labour (IOL) has significant impact on a woman and her baby's health. At a university hospital with an annual delivery rate of 7000, IOL is approaching 30%. The aim of this study was to identify where inductions might be reduced and to identify the impact of IOL on pregnancy outcome, in order to aid decision and patient counselling.
Methods A retrospective analysis of all spontaneous and induced labours occurring over a period of 2 months was performed and delivery outcomes were compared using a number of criteria. The reasons for IOL were compared to NICE guidance.2
Results 284 and 540 women were identified in the IOL and spontaneous labour groups respectively. Parity and gestation were similar in both groups. 10% of inductions were for indications outside NICE guidance. Vaginal delivery was less likely with IOL, 58.8% vs. 70.7%, (p=0.0006). Caesarean sections, 18.0% vs. 8.7%, (p=0.0001), epidural uptake, 49.6% vs. 34.6%, (p<0.0001) and blood loss ≥1500mls, 4.2% vs. 1.1% (p=0.003), were more common with IOL. Differences in instrumental delivery rate, incidence of 3rd/4th degree tears and differences in SCBU admission rate failed to reach significance.
Conclusions Avoiding IOL for non-recognised indications could help reduce IOL and its consequences. In a unit of our size, up to 210 inductions might have been avoided in a year. It is recommended that ‘hospital specific’ guidance be produced in order to limit the impact of IOL on an otherwise healthy population.
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