Prevalence and Predictors of Vaginal Delivery following Induction of Labour at Kawempe National Referral Hospital, Kampala, Uganda

Abstract

Background: Induction of labour has been shown to reduce perinatal morbidity and mortality and World Health Organization (2018) recommended induction of labour at 41 completed weeks of Amenorrhea to reduce the risks associated with post-term pregnancy. The prevalence of Induction of labour has continued to rise in the recent past with 25% of mothers in high income countries undergoing induction of labour to shorten their pregnancy duration compared to low- and middle-income countries where fewer mothers are induced to deliver their babies. Induction of labour is indicated when the risk of waiting for spontaneous onset of labour is thought to be higher than those associated with shortening the duration of pregnancy. Methods: It was a cross- sectional study carried out among mothers who delivered following induction of labour in the labour ward at Kawempe National Referral Hospital. A total of 323 mothers who had induction of labour were selected by consecutive sampling and factors which led to vaginal delivery were identified. Data was collected using interviewer administered questionnaire. Data was entered in epidata version 7 and exported to STATA version 14.0 statistical software for cleaning and analysis. Univariate, bivariate, and multivariate analyses were performed. Any factor with p-value less or equal to 0.05 was considered statistically significant. Results: The prevalence of vaginal delivery following induction of labour was 76.5% and the predictors of vaginal delivery were rupture of membranes (aPR=1.26, 95%CI =1.116-1.416, p=<0.001), use of Intravenous oxytocin for induction of labour (aPR=1.19, 95%CI =1.033- 1.362, p=0.015), adherence to protocol for induction of labor, (aPR=1.32, 95%CI =1.142- 1.551, p=<0.001) and birth weight (aPR=0.68, 95%CI= 0.506-0.913, P= 0.010. Conclusion and recommendations: Prevalence of vaginal delivery following induction of labour at Kawempe National Referral Hospital was high. Rupture of membranes, monitoring of labour as per the protocol, use of intravenous oxytocin were positive predictors while birth weight more than 3.5 kg was a negative predictor of vaginal delivery following induction of labour. We recommend that Clinicians should be encouraged to induce women with indication for induction of labour, hospitals should ensure proper monitoring of mothers is done with an induction of labour monitoring tool to improve success of induction and a study should be done to determine whether delivery is spontaneous or assisted following induction of labour