Indications of Labor Induction at Delivery Room of Maternity Teaching Hospital in Erbil City
Background and objectives: Induction of labour means stimulation of contractions before the birth starts spontaneously, with or without ruptured membranes. The most common indications include oligohydramnios, pre-labour rupture of the membranes, high blood pressure during pregnancy, severe fetal growth restriction, post-term pregnancy, and various maternal medical conditions such as chronic hypertension and diabetes. The aim of the study was to find out the different indications of labour and associated obstetrical factors in a local tertiary hospital.
Methods: A cross-sectional study was conducted among 120 parturient women who attended a delivery room in the Maternity Teaching Hospital in Erbil City from the period of 2nd June to 2nd October 2020. After reviewing the literature, a questionnaire was prepared to obtain socio-demographic data, data related to reproductive characteristic and data related to the indications for labour induction. The data were analyzed using descriptive and inferential statistical approaches.
Results: The study included 120 patients with the highest percentage of the patients (49.1%) were 16 to 23 years old and more than half of the sample (51.6%) had a post-term pregnancy, gestational hypertension and pre-eclampsia (15%). There were highly significant statistical differences between parity, gestational age and indication of labour induction, and significant differences between gravidity and antenatal care visits and indications for labour induction.
Conclusions: The majority of the sample had a post-term pregnancy of 40 and 42 weeks as an indication for induction of labour followed by gestational hypertension and pre-eclampsia, oligohydramnios and pre-labour rupture of membrane. There was a statistically significant difference between the antenatal care visit and parity with the induction of labour.
 Ivars J, Garabedian C, Devos P, Therby D, Carlier S, Deruelle P, et al. Simplified Bishop score including parity predicts successful induction of labor. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2016 Aug 1;203:309-14. Available from: https://www.sciencedirect.com/science/article/abs/piiS0301211516302895[Accessed 1st Sep 2020 ]
 Viteri OA, Sibai BM. Challenges and limitations of clinical trials on labor induction: a review of the literature. American Journal of Psychiatry. 2018 Oct;8(4):e365. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6306280/[Accessed 3rd Sep 2020 ]
 Galal M, Symonds I, Murray H, Petraglia F, Smith R. Postterm pregnancy. Facts, views & vision in ObGyn. 2012;4(3):175. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3991404/ [Accessed 23rd Dec 2020 ]
 Mishanina E, Rogozinska E, Thatthi T, Uddin-Khan R, Khan KS, Meads C. Use of labour induction and risk of cesarean delivery: a systematic review and meta-analysis. Canadian Medical Association Journal. 2014 Jun 10;186(9):665-73. Available from: https://www.cmaj.ca/content/186/9/665.short[Accessed 3rd Sep 2020 ].
 Khireddine I, Le Ray C, Dupont C, Rudigoz RC, Bouvier-Colle MH, De-neux-Tharaux C. Induction of labor and risk of postpartum hemorrhage in low risk parturients. PloS one. 2013 Jan 25;8(1):e54858. Available from: [Accessed 3rd Sep 2020 ].https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0054858
 Banos N, Migliorelli F, Posadas E, Ferreri J, Palacio M. Definition of failed induction of labor and its predictive factors: two un-solved issues of an everyday clinical situation. Fetal diagnosis and therapy. 2015;38(3):161-9. Available from: https://www.karger.com/Article/Abstract/433429 [Accessed 3rd sep 2020 ]
 Obando PV, Arana AN, Izaguirre A, Arana I, Burgos J. Multiscale texture analysis of cervical tissue for labor induction. In2015 IEEE International Workshop of Electronics, Control, Measurement, Signals and their Application to Mechatronics (ECMSM) 2015 Jun 22 (pp. 1-6). IEEE. Available from: https://
ieeexplore.ieee.org/abstract/document/7208707[Accessed 3rd Sep 2020 ]
 Heuser CC, Knight S, Esplin MS, Eller AG, Holmgren CM, Richards D, et al. Tachysysto-le in term labor: incidence, risk factors, outcomes, and effect on fetal heart tracings. American journal of obstetrics and gynaecology. 2013 Jul 1;209(1):32-e1. Available from: https://www.sciencedirect.com/science/article/abs/pii/S0002937813003530 [Accessed 11th Oct 2020 ]
 Pergialiotis V, Fanaki M, Bellos I, Tzortzis A, Loutradis D, Daskalakis G. Evaluation of umbilical cord entanglement as a predictive factor of adverse pregnancy outcomes: A meta-analysis. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2019 Dec 1;243:150-7. Available from: https://www.sciencedirect.com/science/article/abs/pii/S0301211519304944 [Accessed 3rd Sep 2020 ]
 Harper LM, Cahill AG, Boslaugh S, Odibo AO, Stamilio DM, Roehl KA, et al. Association of induction of labor and uterine rupture in women attempting vaginal birth after cesarean: a survival analysis. American journal of obstetrics and gynecology. 2012 Jan 1;206(1):51-e1.Available from: https://www.sciencedirect.com/science/article/abs/pii/S0002937811012099[Accessed 3rd Sep 2020 ]
 Kim HI, Choo SP, Han SW, Kim EH. Benefits and risks of induction of labor at 39 or more weeks in uncomplicated nulliparous women: a retrospective, observational study. Obstetrics & gynecology science. 2019 Jan 1;62 (1):19-26. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6333763/[Accessed 8th Sep 2020 ]
 Parkes I, Kabiri D, Hants Y, Ezra Y. The indication for induction of labor impacts the risk of cesarean delivery. The Journal of Maternal-Fetal & Neonatal Medicine. 2016 Jan 17;29(2):224-8. Available from: https://www.tandfonline.com/doi/abs/10.3109/14767058.2014.993965 [Accessed 8th Sep 2020 ]
 Mei-Dan E, Pittini A, Barrett J, Melamed N. 945: Indication for induction of labor and risk for cesarean section. American Journal of Obstetrics & Gynecology. 2017 Jan 1;216(1):S534-5. Available from: https://www.ajog.org/article/S0002-9378(16)31833-6/abstract[Accessed 8th sep 2020 ]
 Yamane T. Statistics, An Introductory Analysis. 2nd ed. New York: Harper and Row, 1967.
 Abdulkadir Y, Dejene A, Geremew MA, Dechasa B. Induction of labor prevalence and associated factors for its outcome at Wolliso St. Luke. Catholic Hospital, South West Shewa, Oromia. Internal Medicine. 2017;7(255):2. Available from: https://www.longdom.org/open-access/induction-of-labor-prevalence-and-associated-factors-for-its-outcome-atwolliso-st-luke-catholic-hospital-south-west-shewa-oromia-2165-8048-10002455.pdf[Accessed 8th Sep 2020 ]
 Regmi RP, Regmi MC, Agrawal A, Uprety D, Katwal B. Indications for Induction of Labour: A Prospective Analysis. Health Renaissance. 2010;8(2):114-6. Available from:https://www.researchgate.net/publica-tion/277854959_Indications_for_Induction_of_Labour_A_Prospective_Analysis [Accessed 18th Oct 2020 ]
 Lawani OL, Onyebuchi AK, Iyoke CA, Okafo CN, Ajah LO. Obstetric outcome and significance of labour induction in a health resource poor setting. Obstetrics and gynaecology international. 2014 Jan 1;2014. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3918372/[Accessed 18th Oct 2020 ]
 Quitolina Scapin S, Petters Gregório VR, Sorgatto Collaço V, Knobel R. induced la-bor in a university hospital: methods and outcomes. Texto & Contexto Enfermagem. 2018 Jan 1;27(1). Available from: https://www.scielo.br/scielo.php?script=sci_arttext&pid=S0104-07072018000100300&lng=en&nrm=iso&tlng=en[Accessed 18th Oct 2020 ]
 Dundar Ö, Çiftpınar T, Tütüncü L, Ergür AR, Atay MV, Müngen E. The effects of the pre-pregnancy maternal body mass ındex on the pregnancy outcomes. Perinatal Journal. Available from: https://perinataljournal.com/Files/Archive/en-US/Articles/PD-1052.pdf[Accessed 18th Oct 2020 ]
 El-Gilany AH, Hammad S. Body mass index and obstetric outcomes in Saudi Arabia: a prospective cohort study. Annals of Saudi medicine. 2010 Sep;30(5):376-80. Available from: https://www.annsaudimed.net/doi/pdf/10.4103/0256-4947.67075
[Accessed 20th Oct 2020 ]
 Whittington JR, Ounpraseuth ST, Magann EF, Wendel PJ, Newton L, Morrison JC. A comparison of maternal and perinatal outcomes with vaginal delivery: indicated induction versus spontaneous labor. The Journal of Maternal-Fetal & Neonatal Medicine. 2020 Jun 3:1-6. Available from: https://www.tandfonline.com/doi/abs/10.1080/14767058.2020.1774545?journalCode=ijmf20 [Accessed 20th Oct 2020 ]
 Ekéus C, Lindgren H. Induced Labor in Sweden, 1999–2012: A Population-Based Cohort Study. Birth issues in prenatal care. 2016 Jun;43(2):125-33. Available from: https://onlinelibrary.wiley.com/doi/full/10.1111/birt.12220 [Accessed 20th Oct 2020 ]
 Jaiswal S. Indications, methods and outcome of induction of labor at Muhimbili national hospital, Dar es salaam, Tanzania (Doctoral dissertation, Muhimbili University). Available from:http://dspace.muhas.ac.tz:8080/xmlui/handle/123456789/2259[Accessed 24th Oct 2020 ]
 Lueth GD, Kebede A, Medhanyie AA. Prevalence, outcomes and associated factors of labor induction among women delivered at public hospitals of MEKELLE town-(a hospital based cross sectional study). BMC Pregnancy and Childbirth. 2020 Dec;20:1-0. Available from:https://bmcpregnancychild-birth.biomedcentral.com/articles/10.1186/s12884-020-02862-7 [Accessed 8th Sep 2020 ]
 Kandemir O, Dede H, Yalvac S, Aldemir O,Yirci B. The effect of parity on labor induc-tion with prostaglandin e2 analogue (dinoprostone): An evaluation of 2090 cases. Journal of Pregnancy and Child Health 2015;2(149):2. Available from: https://www.researchgate.net/publication/277907708 [Accessed 24th Oct 2020 ]
 Abdulkadir Y, Dejene A, Geremew MA, Dechasa B. Induction of labor prevalence and associated factors for its outcome at Wolliso St. Luke. Catholic Hospital, South West Shewa, Oromia. Internal Medicine. 2017;7(255):2. Available from: https://www.longdom.org/open-access/induction-of-labor-prevalence-and-associated-factors-for-its-outcome-atwolliso-st-luke-catholic-hospital-south-west-shewa-oromia-2165-8048-10002455.pdf [Accessed 26th Oct 2020 ].
Copyright (c) 2021 Erbil Journal of Nursing and Midwifery
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.