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n South African Journal of Obstetrics and Gynaecology - Induction of labour at a regional hospital in KwaZulu-Natal, South Africa : research
Background. Clinicians working in maternity units must recognise the risks associated with induction of labour (IOL). They need to analyse the indications for IOL, methods used and outcomes on a regular basis to reduce complications.
Objective. To determine the indications for IOL and outcomes of current methods at a regional hospital in rural KwaZulu-Natal, South Africa.
Methods. Clinical data for all patients who had IOL over an 8-month period were collected and analysed.
Results. There were 6 649 deliveries, and of these patients 532 had IOL (induction rate 8.0%); 502 patient files had complete information for analysis. The main indications for IOL were hypertensive disorders of pregnancy (43.6%, n=219), post-dates pregnancy (25.9%, n=130) and pre-labour rupture of the membranes (14.7%, n=74). Other indications accounted for 15.7% of cases (n=79). The most common methods of IOL were oral misoprostol (63.5%, n=319) and vaginal misoprostol (30.3%, n=152). Vaginal deliveries were achieved in 59.8% of patients (n=300), and 40.2% (202) had caesarean sections (CSs); 69.7% of patients (n=350) delivered within 24 hours (this includes CSs and vaginal deliveries). Normal vaginal births within 24 hours accounted for 44.4% of total deliveries (n=223), and CSs within 24 hours for 24.3% (n=122). There were 34 babies (6.8%) admitted to the neonatal intensive care unit. Prematurity accounted for 10 of these admissions (2.0% of all babies), hypoxic ischaemic encephalopathy for 9 (1.8%), and congenital pneumonia for 7 (1.4%). There was 1 early neonatal death.
Conclusion. Current methods of IOL at the rural study site are associated with outcomes similar to those in a report from an urban regional hospital in South Africa.
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