Publication:

An observational study on indications and outcomes of induction of labour in a tertiary maternity unit

Background Induction of labour (IOL) is the artificial initiation of uterine contractions when continuation of pregnancy may increase maternal or fetal risk. Common indications include post-term pregnancy, premature rupture of membranes (PROM), hypertensive disorders of pregnancy, oligohydramnios, and suspected fetal compromise. This study aimed to evaluate the indications for IOL and to assess associated maternal and neonatal outcomes in a tertiary maternity unit.

Methods This prospective observational study included 172 term women (37-41 weeks) undergoing IOL at ACS Medical College, Chennai, over 8 months, from January to June 2025. Patients with spontaneous labour or prior caesarean were excluded. Maternal demographics, indications, induction methods, labour course, delivery mode, and maternal and neonatal outcomes were recorded.

Results The mean maternal age was 27.8±4.2 years, with 61.6% nulliparous, 99.4% booked, and 0.6% unbooked cases. The main indications for IOL were post-term pregnancy (26.7%), PROM (22.1%), hypertensive disorders (14%), oligohydramnios (10.5%), and foetal compromise/IUGR (5.8%). Misoprostol/PGE₂ gel was used in 60.5%, Foley balloon±oxytocin in 17.4%, and ARM±oxytocin in 22.1% of cases. Spontaneous vaginal delivery occurred in 58.7%, operative vaginal delivery in 4.7%, and caesarean section in 36.6%. Indication for LSCS was primarily due to failed induction (46%) or foetal distress (28.6%). Maternal complications included PPH (9.3%) and hyperstimulation (4.1%). Neonatal outcomes included a mean birth weight 3010±420 g, Apgar <7 at 1 min in 8.1%, NICU admission 12.8%, and perinatal mortality 1.2%.

Conclusions IOL in this tertiary unit effectively achieved vaginal delivery in most women. Post-term pregnancy, PROM, and hypertensive disorders were common indications. Prostaglandins were mainly used, with minor maternal and neonatal complications.