Induction of Labour Audit-Fauji Foundation Hospital Rawalpindi
Objective: The objective of audit was to see the short falls in the process and indications of induction of labour in our hospital so that changes could be made to ensure that induction is carried out only when indicated, and the process should meet specified standards. This will help improve our local standard for induction of labour and hence patient care.
Study Design: A retrospective audit.
Place and Duration: Department of Obstetrics and Gynaecology Unit ll, Fauji Foundation Hospital, 1st January to 31st December 2015.
Methodology: The study was carried out in Fauji Foundation Hospital to look at the indications, process and outcome of induction of labour and see whether this meets the NICE guidelines for induction of labour. All patients with singleton pregnancy at a gestation age > 34 weeks who underwent induction of labour were included in the audit. The indication, method and outcome of induction of labour (IOL) was assessed and evaluated in all patients.
Results: The overall rate of induction in our hospital was 42 %. The success rate of Induction of labour was 78%. Major indications for cesarean section were fetal distress and failed induction of labour. Both factors were evaluated in detail. Regarding failed induction of labour it was noted that induction of labour for post dates leading to caesarean section, were mostly done at 40 + weeks but prior to 41 weeks. Similarly patients with Pre labour rupture of membranes (PROM), in the absence of chorioamnionitis were induced within 6 hours instead of waiting for 24 hours. Interval induction was not considered as an alternative option.
Conclusion: Recommendations are made on the basis of this audit and it is recommended to re-audit in the near future to see implementation of the recommendations.