Analysis of classification systems and outcome of labor in women undergoing induction of labor in south indian population

Abstract

Aim and objective: To identify women undergoing induction of labor (IOL) for 1 year in our tertiary care hospital, apply the classification systemcorrelate with the maternal and fetal outcomes, and determine the ease and effectiveness of audit of the IOL practice. Materials and methods: All patients who delivered in the year 2019 were analyzed, and the cohort of women who underwent IOL was identifiedThe age, parity, gestational age at induction, indication for induction, and the maternal and fetal outcomes were analyzed. The two classificatiosystems were applied and the results were analyzed. Results: The total number of deliveries for the year was 3,668, and the number of women undergoing IOL was 1,450, with an incidence of 39.5%. The maximum number of women, 1,212, (83.5%) were in the 20–30-year age-group; in that, 1107 (76.34%) were primiparous and 343 (23.66%) were multiparous. The commonest indication for IOL was postdates, with the commonest mode being PGE2 gel in 699 (48.2%) women. Of 1,450 women induced, 1,083 (74.69%) had a vaginal delivery and 367 (25.31%) delivered by a cesarean section. This was similar to the rate seen in women with spontaneous labor. Further, a 10-group classification system according to Nippita et al. and classification of IOL according to the indication for induction proposed by Mahomed et al. was applied to this cohort. Conclusion: The classification systems are useful to determine whether the induction is done according to the established guidelines and makeour audit easier. A prospective audit would better identify some of the adverse maternal and fetal outcomes. Clinical implications: The safety of IOL in modern obstetrics should not give us a false sense of security, and regular audits of the practice of IOL are useful to ensure that the adherence is according to the established guidelines.