Association of induction of labor in primigravidae with cesarean section and post partum hemorrhage in Omdurman maternity hospital, Sudan 2007

Abstract EN

Objective: this is a descriptive cross-sectional hospital based study, to determine Cesarean Section (C/S) rate and post-partum hemorrhage (PPH) in association with induction of labor in primigravidae and risk factors behind that, in Omdurman maternity hospital during the year 2007. Methods: After an informed consent from patients and hospital directorate, 105 primagravidae with singleton pregnancy, were induced after completed 37 weeks for various indications, and 105 primagravidae delivered spontaneously were carefully selected for control with minimal confounders including age, education and maternal medical disorders.

Fifty four cases (51.4%) were induced with artificial rupture of membranes (ARM), followed by oxytocin titration only, while 51 cases (48.6%) were induced with intra-vaginal misoprostol followed by ARM and oxytocin titration. Results: In this study, rate of induction in primigravida was 6.1%, mainly due to post date (53.3%).

Cesarean section was significantly higher in induced patients (36.2%) than in control group (18.0%).

Fetal distress was the commonest indication for C / S 17.1%, followed by failure of induction 13.3% and failure to progress 5.7%.

No significant difference observed in PPH following induction or spontaneous labor. Conclusions: Induction of labor in primigravida is associated with an increased risk of C / S; however, there is no significant difference in association with PPH.