Publication:

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

Background The objective of the stusy was to ascertain any differences in fetomaternal outcomes in induced and spontaneous labour among primiparous women delivering at term without an identified indication for induction.

Methods This was a prospective study of 500 women with spontaneous labour and 204 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 78% compared to 46% in spontaneous group (p<0.001). Mean duration of total labour (9.1+4.42 Vs 8+4.41 hours), first stage of labour (8.5+2.3 Vs 7.4+1.6 hours) was significantly short in induced group as compared to spontaneous group (p<0.001). Induced subjects had higher incidence of caesarean delivery compared with spontaneous group (p=0.016), interestingly incidence of instrumental delivery was insignificantly higher in spontaneous group compared to induced group (7.8% vs. 3.9%, p=0.06), 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 Primipara who has spontaneous onset of labour the initial mean Bishop score is more compared to the subjects who have induced labour.  The study demonstrated a significant increase in rate of caesarean section when Bishop Score was ≤5 (p=0.047). Compared to those with spontaneous labour, primiparas with induced labour are more likely to have short duration of labour specially the first stage and higher incidence of caesarean delivery.