Factors Associated With Failed Induction of Labour in Patients Undergoing Induction with Titrated Oral Misoprostol at Harare Maternity Hospital
Abstract
Objective: To assess factors associated with failed induction in patients induced with oral misoprostol at 37 completed weeks of gestation or more.
Methods: A prospective cohort study was conducted on pregnant women with singleton fetuses in cephalic presentation undergoing induction of labour with titrated oral misoprostol at a tertiary hospital in Zimbabwe. The sample size was 171. Participants were given between 15ml to 30ml of a 1mcg/ml solution of oral misoprostol hourly and this was discontinued following the onset of labour pains. The main outcome measure was vaginal delivery within 24 hours of completing one cycle of titrated oral misoprostol.
Results: Only maternal body mass index (hazard ratio: 0.952; p value=0.026), the total dose of misoprostol (hazard ratio of 0.977; p value<0.001), and the Bishop score (chi square 17.72; p value=<0.001) were significantly associated with the outcome of induction. The rate of failed labour induction was 24.9%.
Conclusion: Maternal body mass index, the total dose of misoprostol and the Bishop score significantly affected
outcome of induction. The rate of failed induction with oral misoprostol was high but this was significantly
reduced by repeating induction of labour when indicated.
