Pregnancy outcomes of catheter induction among term mothers with indications for labour induction in New Mulago Hospital

Abstract

Background: The use of the transcervical FBC for cervical ripening has been shown to be an efficient, safe and cost effective method to induce labour, and is associated with a low incidence of uterine contractile abnormalities. It is used for labour induction in women with an unfavorable cervical assessment. FBC induction provides an option for cervical ripening when there are contraindications to pharmacological agents. There has been low uptake of catheter induction in Uganda than elsewhere. No study to assess the outcome of FBC induction and determinants of uptake had as yet been done in Uganda. Objective: To determine the maternal and fetal outcomes of FBC induction of labour in mothers admitted at term with indication for induction of labour and to assess the factors that promote or hinder the adoption of the method in new Mulago Hospital. Methods: This was an implementation research study carried out on132 pregnant mothers at term with indications for induction of labour in Mulago hospital. The maternal and fetal outcomes were determined and documented. Results: We had a 70.46% successful delivery rate within 24hrs. The interval from induction to active labour was ≤10hr and improvement of Bishops score from 1-2 to ≥ 7 after 12hrs of catheter induction. Babies’ Apgar score was 8-10 among 94.4% babies. There were very few adverse fetal or maternal outcomes. Health workers interviewed showed hesitance to use the methods because of lack of training and suspicion of lack of effectiveness, causing infection and patients fears. They were willing to use the FBC if they had adequate supply, were given training and the patients were adequately informed. Conclusion: This study has shown that FBC induction can be used with good pregnancy outcomes among term mothers in Mulago hospital. Specifically demonstrated were significant improvement in bishop’s score within 12 hours of catheter insertion and almost no adverse outcomes for mother and baby. It has also shown how the use of the catheter can be increased by providing adequate supplies and giving health worker training and patient information.