Evaluating Factors Associated with Failed Induction of Labour in Patients Undergoing Induction with Titrated Oral Misoprostol at Harare Hospital Maternity

Mateveke, Bismark (2013) Evaluating Factors Associated with Failed Induction of Labour in Patients Undergoing Induction with Titrated Oral Misoprostol at Harare Hospital Maternity. Masters thesis, University of Zimbabwe.

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Abstract

spontaneous onset of labour, in order to achieve vaginal birth, when the risks of continuation of the pregnancy outweigh the benefits. This is usually preceded by a process of cervical ripening involving softening, thinning, and partial dilatation of the cervix1. The rates of labour induction vary widely with a reported 25% incidence in developed countries, the rates for developing countries being generally lower. The WHO global survey on maternal and perinatal health showed an overall rate of induction of labour of 9.6% with the highest rates being found in Asian and Latin American countries (Sri Lanka 35.5%) and the lowest rates in African countries (Niger 1.4%)2. In 2004 and 2005, 1 in 5 deliveries in the UK was as a result of induction of labour3. In the United States the rates of labour induction have increased from 10.9% of all pregnancies in 1989 to 20.6% in 2003. At Harare Hospital Maternity the rate of induction of labour is reported at around 7% to 10%26. Induction of labour based solely on maternal request, to shorten pregnancy duration and time the birth of the baby, with no associated fetal or maternal medical indications, has been reported in developed countries4. Induction of labour can be achieved through various non pharmacological (mechanical) and pharmacological methods. The mechanical methods include use of a traction catheter (balloon), extra amniotic saline infusion, osmotic dilators like hygroscopic laminaria and amniotomy .There is however insufficient evidence to assess their effectiveness against placebo or no treatment but they tend to be associated with a lower risk of uterine hyperstimulation, fetal heart rate abnormalities and incidence of caesarean section compared with pharmacological methods. Pharmacological methods include the use of oxytocin and prostaglandins mainly, though there are other novel approaches employing mifepristone, relaxin, and oestrogen and nitric oxide donors like glyceryl trinitrate. Misoprostol is now being widely used off label for cervical ripening and induction off labour due to its low cost, availability and uterotonic activity. New label for use of misoprostol in pregnancy for inducing uterine contractions was approved by U.S FDA in 2002.

Item Type:	Thesis (Masters)
Subjects:	R Medicine > RG Gynecology and obstetrics
Divisions:	Africana
Depositing User:	Geoffrey Obatsa
Date Deposited:	24 Apr 2018 12:41
Last Modified:	24 Apr 2018 12:41
URI:	http://thesisbank.jhia.ac.ke/id/eprint/3789

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