High risk pregnancy outcome following induction of labour

Objective: To evaluate whether induction of labour, performed in a high risk obstetric population, when medically indicated, carries an increased risk for operative delivery and maternal and fetal complications. The secondary goal was to study the effect of the various induction methods used on these outcomes and labour time. Study design: This study was carried out at a level 111 university hospital. A group of 210 women who were induced for various indications, were compared to our general parturient population. Main outcome measures were cesarean section (CS) and instrumental delivery rates, intra-partum and post-partum complications, APGARs 1' and 5' and labour time by induction method. Results: No significant increase in the rates of primary CS (8.6 vs. 7.1%) and instrumental delivery (15.7 vs. 12.7%), were found in the induction high risk group as compared to our general obstetric population. Intra-partum complications and fetal outcome were comparable in both groups. A comparison of methods of induction used (oxytocin, PgE₂, Amniotomy) revealed a less favorable outcome with the oxytocin induction method which showed an elevated intra-partum complication rate (P < 0.01) and a tendency toward lower Apgar scores and higher CS rate. Conclusions: Induction of labour performed in a high-risk obstetric population is safe, carrying no significant increase in CS and neonatal complication rates. Of the three methods of induction used, oxytocin induction showed the least favorable outcome for both mother and her offspring.