Abstract

Labour induction is one of the most common obstetric interventions. According to most
current studies, the rate varies from 9-33% of all pregnancies annually. According to
American Congress of Obstetricians and Gynecologists, one-fifth of all pregnancies are
terminated with the induction method. The aim of induction is to prevent maternal and fetal
disorders such as preeclampsia, premature rupture of membranes, intrauterine growth
retardation and prolonged pregnancy. Since the purpose of induction is vaginal delivery, a
number of authors consider successful induction as vaginal delivery without regarding to
the time limits. Induction failure is defined as failure of induction leading to cesarean
section. The aim of this study was to determine the relationship between induction and risk
of cesarean section delivery for women with term pregnancies who were admitted to Mbarara
Regional Referral Hospital. A hospital based retrospective cohort study was conducted using
maternally-linked data from MRRH birth registry. The study was restricted to deliveries
intervened by labor induction at Mbarara Regional Referral Hospital during the year 2019 to
2021. Study samples size were 180 cases using convenience sampling among eligible
pregnant women admitted to MRRH for induction. Data analysis was performed using SPSS
version 21. Chi-square and t-test were used to compare groups with significant levels of less
than 0.05, and logistic regression test was used to determine odds ratio with 95% confidence
level. The mean age of those who underwent induction were 26.7 ± 5.6 years. In terms of
education, 63.3 % were at the elementary level, the majorities (94.6%) were housewives or
unemployed prior to delivery, and 57.4% were nulliparous. The prevalence of cesarean
section was 22.21%. The mean gestational age was 39.3 ± 2.6 weeks and post-term
pregnancies (40.63%), and PROM (24.12%) were among the most common causes for
induction. Dilatation and birth weight were factors predicting labour induction success.
Furthermore, performing Induction in dilatation 3 cm or less was associated with an
increased risk of cesarean delivery. The prevalence of caesarean section after induction of
labour in this study was 22.1%. Cervical dilatation (3 cm or less) prior to induction and
increasing birth weight could be the major factors leading to caesarean section, hence
predicting labor induction success. More funding is necessary by the hospital to further give more light to the all-time prevalence of cesarean section following labor induction within MRRH