Audit on current practices of induction of labour at a tertiary care hospital

Abstract

OBJECTIVE: Induction of labour (IOL) is a common obstetric intervention done for several reasons. Most importantly, induction of labour has a large impact on the health of women and their babies and so needs to be clearly clinically justified. Yet it is also important to perform regular audit of this practice on account of ensuring risk-free medical practice. Thus, current practice of IOL was examined to assess the indications and outcomes of IOL. METHOD: This audit was carried out from January 2016 to April 2016 in obstetric professorial unit of Colombo north teaching hospital Ragama. Data on all women admitted for IOL was collected using data collection sheet. The processes of IOL were tested against the WHO clinical guideline. It was aimed to determine the IOL rate, reasons, and outcomes. RESULTS: Out of the1423 deliveries during those periods 377 were induced (26.49%). Mean maternal age was 28.08-years and mean gestation was 39-weeks. Number of successful induction was 286.The most common indications for IOL were: prolonged rupture of membranes (29.4%), prolonged pregnancy (20.7%) diabetes complicating pregnancy (12.2%), hypertensive disorders (9.8%), and small for gestational age (5.1%). Reason for IOL was not documented in 20% and rests of the IOL were due to social, IUD and other medical disorders. The most common indications at <37 weeks were prolonged rupture of membranes (52%) and small for gestational age (17%). Emergency caesarean section was 19.3% for lack of progress and fetal distress. Seventeen percentages of neonates were admitted for NICU and 96% had APGAR more than 7 at 7 minutes. CONCLUSION: Our unit IOL proportion is lower than national figure (35.5%).One fifth of the IOL indications were not documented and this highlights the deficiency in the documentation. Checklist for IOL has been decided in the unit meeting to enhance proper documentation.