PREVALENCE, REASON AND OUTCOME OF INDUCTION OF LABOUR AMONG WOMEN OF CHILD BEARING AGE AT THE BUEA REGIONAL HOSPITAL

Abstract

Induction of labour is the process of artificially stimulating the uterus to start labour. It can be also be the process or treatment that stimulates childbirth and delivery. It is usually performed by administering oxytocin or prostaglandin to pregnant women or by manually rupturing the amniotic membranes.

The main objective of this study is to determine the proportion, reasons and outcomes of induction of labour among women of childbearing age at Buea Regional Hospital.

This study was a retrospective and prospective cross sectional study in which the record of women who gave at the Buea Regional Hospital from 2017 to 2020 was assessed.

The target population were women who have come for delivery  at Buea Regional Hospital and the sample size was 108 women.

CHAPTER ONE

INTRODUCTION

1.1 Background of the Study

Induction of labour is a process of artificially stimulating the uterus to start labour (WHO, 2000). It can also be the artificial initiation of labor before its spontaneous onset for the purposed of delivery of the fetus and placenta (Martin et al; 2008). It is the process or treatment that stimulates childbirth and delivery (Caroline, 2017).

It is usually performed by administering oxytocin or prostaglandin to the woman or by manually rupturing the amniotic membranes (WHO, 2000). It continues to be among the most common performed procedures in obstetric practices in many developed countries (martin et al., 2008). Mishanina and Rogozinnska (2014) indicate in west countries, it is estimate that one quarter of pregnant women has their labor medically induced with drug treatment.

History of labor inducting goes back to Hippocrates time when nipple stimulating and mechanical dilatation of cervix utteri were used for the first time as a means of labor induction (Muhlstein et al., 1986). Although since then many other forms of mechanical methods have been used for induction and augmentation of labor, commercial availability of synthetic oxytocin did not occur until n the 20th century (Boissonnass et al., 1955 et al., 1956).

Induction of labour is widely practiced to prevent problems or outcomes such as caesarean section, prolonged labor, postpartum hemorrhage and traumatic birth (caughey, 2004). It is also carried out to improve health outcomes for women and their infants. In the world in general and in Cameroon in particular, nearly one in four births in induced with a prevalence of 23.8% in 2015 (Martin, 2017) .

For post term pregnancies, it may be one in every two births with 52% induction rate for gestation > 41 weeks as reported by Wolff (2016). Variation in rates of post term births suggests that different policies and practices for managing post term pregnancies exist (Zeitlin, 2007). There is concern about the high and increasing induction rate in many countries, and in Cameroon in particular and increasing caesarean rates despite increasing induction rates (Keirse, 2010

1.2 Statement of the Problem

Induction of labour has become one of the most common interventions in modern obstetrics (Al-Shaikh et al., 2012). It is frequently used to avoid serious complications to the mother or the fetus, arising from conditions like pre-eclampsia, pre-term rupture of the membranes, intrauterine growth restriction and post-term pregnancy.

Nevertheless, induction of labour may result in undesirable effects such as increased cesarean section (CS) rates, post-partum hemorrhage and fetal distress (Vardo et al., 2011). It should only be considered when the benefits to the mother and her fetus outweigh the risks of waiting for spontaneous onset of labor.

Moreover, induction of labour , as a medical intervention, increases the cost of medical care compared to spontaneous labor, and such excess cost can be justified, if the indication for induction of labour alleviate a risk to the mother or the fetus, who should otherwise be delivered by CS (Kaufman et al., 2002).

Like many other obstetrics population statistics, the national rate of induction of labour in the Cameroon is not known. However, knowledge of the determinants of induction of labour at the Buea Regional Hospital may be employed as a foundation for a database to monitor rates, and outcome of induction of labour for the hospital and similar hospitals in the country. This necessitated this study to determine the proportion, reasons and outcomes of induction of labor at Buea Regional Hospital to be carried out.

1.3 Research Objectives

1.3.1 Main objective

The main objective of this study will be to determine the proportion, reasons and outcomes of induction of labor among women of child bearing age at Buea Regional Hospital.

1.3.2 Specific objectives

1. To determine the proportion of induction of labour among women of child bearing age at the Buea Regional Hospital.
2. To determine the reasons of induction of labor among women of child bearing age at the Buea Regional Hospital.
3. To determine the outcomes of induction of labor among women of child bearing age at the Buea Regional Hospital.

1.4 Main research question

What are the proportion, reasons and outcomes of induction of labor among women of child bearing age at the Buea Regional Hospital?

1.4.1 Specific questions

1. What are the reasons of induction of labor among women of child bearing age at the Buea Regional Hospital?
2. What are the outcomes of induction of labor among women of child bearing age at the Buea Regional Hospital?