A prospective study of the induction of labour at Rahima Moosa Mother and Child Hospital

Abstract

Background Induction of labour implies the artificial initiation of regular uterine contractions before the onset of spontaneous contractions with the purpose of achieving a vaginal delivery. This study aimed to compare the use of oral misoprostol and vaginal dinoprostone to determine differences in the labour process and the delivery methods. Maternal and fetal outcomes were also compared.

Methods This is a prospective cross-sectional analytical study using medical record review at the Rahima Moosa Mother and Child Hospital (RMMCH) in Newclare, Johannesburg. This study included all women undergoing the induction process, who met inclusion criteria from 01 January 2016 to 30 April 2016.

Results This study included 95 women. Forty-nine women received dinoprostone and 46 women received oral misoprostol. There was minimal heterogeneity between the demographics of the two groups. The differences in the indications for induction were statistically significant (p = 0.001). There was no statistical difference in the time from induction to delivery (p= 0.18), the duration of labour (p=0.10) or in the time from induction to onset of labour (p= 0.37). There was a caesarean section rate of 32.7% in the dinoprostone group and 43.5% in the oral misoprostol group (p=0.30). There was no statistical significance between fetal and maternal outcomes.

Conclusions This study yielded no difference in the labour process, time to delivery, or maternal and fetal complications between the two groups. Labour was initiated in more patients in the dinoprostone group and dinoprostone resulted in fewer c/s than misoprostol, however this was not statistically significant. There was no difference in neonatal and maternal outcomes. The use of dinoprostone or misoprostol is therefore equally effective in our setting. A larger study or RCT is recommended to adequately assess neonatal and maternal complication rates.