Obstetrics & Gynaecology Forum Volume 29 | Issue 3 | 2019

Background Induction of labour (IOL) is the initiation of the delivery process, a commonly performed procedure, which is more bene cial to the mother and baby than that of continuation of pregnancy. 1-3 Induction of labour can be achieved through various non pharmacological (mechanical) and pharmacological methods. Mechanical IOL includes cervical dilators, amniotomy which is the arti cial membrane rupture and breast stimulation amongst several others. 4 Oxytocin as well as prostaglandins are some of the pharmacological methods used. 5, 6 Misoprostol is a unique prostaglandin E1 analogue that has wide application in clinical medicine including cervical ripening and labour induction. 7, 8 It can be administered via the vaginal, 9 oral, 10 and sublingual 11 routes. It has been used for IOL in cases of an unfavourable cervix (Bishop score <6). 12 Contraindications for its use include previous caesarean delivery, placenta praevia, coronary heart disease, asthma and cephalopelvic disproportion. 13 e risks with misoprostol use are uterine hyperstimulation and rupture. 14 Several studies have shown that with justi ed indications for IOL, proper patient selection and adequate maternal and fetal monitoring, misoprostol is safe and is recommended by the World Health Organization (WHO). 15-17 However, it fails to induce labour in 5-20 % of women at term. 18 Globally, it is estimated that 10%of all deliveries involve IOL. In South Africa (SA), there was an 8% incidence of IOL. 19 is was particularly seen at the Lower Umfolozi District War Memorial Hospital, SA. 19 Malende et al., (2014) further showed that at this hospital, there were various indications for IOL which included pre-labour membrane Factors associated with successful induction of labour with oral misoprostol in term or post-term pregnancies Abstract Background Induction of labour (IOL) is commonly performed for the benefit of either the mother and baby, or both, where continuation of the pregnancy is deemed to have potential to yield adverse outcomes. Objectives To establish factors associated with successful IOL with oral misoprostol in term or post-term pregnancies amongst parous women. Methods This was a retrospective cohort study at Mahatma Gandhi Memorial Hospital (MGMH) in Durban, South Africa. A total of 205 pregnant women, ≥ 16 years with parity ≥ 1 and gestational age of ≥ 37 weeks were included. IOL was performed with oral misoprostol. Various factors were assessed as potential predictors and associations for successful IOL. Results Incidence of IOL was 14.6% at MGMH. The majority of the patients were 26-30 years. Induction was successful in 50.7% of cases. The common indications for IOL were post-dated pregnancy, hypertensive disorders of pregnancy and pre-labour rupture of membranes. The commonest causes of failed induction resulting in a caesarean section (CS) were fetal distress, cephalopelvic disproportion and unresponsiveness to misoprostol. High BMI was significantly associated with failed IOL (31.9±6.8 versus 29.2±5.7; p=0.002). Misoprostol doses correlated positively with BMI (r=0.142; p=0.04). The higher the BMI, the more misoprostol doses were required. Conclusion BMI influences IOL success and is positively correlated with misoprostol doses administered. Keywords: Pregnancy, Gestation, Induction of labour, Oral misoprostol, Body mass index Correspondence Dr J.M. Boshomane email: johnmalbosho@webmail.co.za J.M. Boshomane 1 , H.M. Sebitloane 1 1 Discipline of Obstetrics and Gynaecology, School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa O&G Forum 2019; 29: 25 - 28 ORIGINAL OBSTETRICS & GYNAECOLOGY FORUM 2019 | ISSUE 3 | 25