Iraqi Postgraduate Medical Journal

Abstract

ABSTRACT:
BACKGROUND:
Induction of labor (IOL) implies stimulation of uterine contractions before the spontaneous onset of labor, with or without ruptured membranes. The condition or favorability of the cervix is important to labor induction. Induction to active labor is usually successful with a cervical score of 9 or greater.
OBJECTIVE:
(A) to estimate the cesarean section rate for induction of labor with low dose Oxytocin in the presence of unfavorable cervix. (B) To analyze the possible predictors of unsuccessful induction.
PATIENTS AND METHOD:
This is a case series study done at Al-Batool Maternity Teaching Hospital with a total of 13000 deliveries per year.
Eighty pregnant ladies that underwent labor induction at 37 weeks of gestation or more with an unfavorable cervix (Bishop score
5). The study was conducted at Al-Batool Maternity Teaching Hospital in Mosul, north of Iraq from January to August 2005. The patients were assigned to receive 2 mIU/ min. oxytocin in one pint of intravenous fluid at day one. When contractions did not start by this dose, the patient is postponed to the second day to receive 2 and 4 mIU/min. oxytocin in two pints, respectively. If there was no response, we started the third day with 4, 8 and 16 mIU/min. in 3 pints, respectively, maintaining these doses if the contractions started. The primary outcomes were successful induction rate and cesarean delivery rate and fetal condition at birth.
RESULTS:
Primary cesarean delivery rate was (27.9%). Increasing Bishop Scores decreased the risk of failed induction.
CONCLUSION:
The use of the daily repeated low dose oxytocin infusion with gradual increase in this study is safe and may reduce the high rate of operative delivery associated with induction of labor