Failed Induction of Labour (IOL) Due to Maternal Obesity
Objective: To determine the influence of maternal obesity on labour induction among pregnant women at tertiary care Hospital Karachi.
Methodology: This case series study was conducted at the Obstetrics and Gynaecology department of Jinnah Postgraduate Medical Centre, Karachi from October 2016 to October 2017. Women aged between 18-40 years, gestational age between 36-42 weeks on ultrasonography, alive singleton pregnancy and obese patients undergoing induction of labour and with cervix dilatation <2 cm were included. Prostaglandin E2 was inserted vaginally. Maximum two PGE2 doses were inserted depending on the Bishop score. Induction was considered failed when there was a failure to establish labour within 6 hours of the second vaginal prostaglandin treatment. All the data was recorded via study proforma.
Results: The mean age of patients was 29.08±5.66 years. Mean BMI was 35.89±4.06 kg/m2. Among indications of induction of labour, 47% were post term gestations, 32% were pre-labor rupture of membranes and 21% were maternal indications for labor induction. Failure of induction of labor was found to be 34%. There was a significant association of failure of labor induction with higher BMI and parity >2 (p=<0.05).
Conclusion: High body mass index, during pregnancy, increases the likelihood of prolonged pregnancy along with increased rates of failed induction of labor (IOL). The women with high BMI are more likely to undergo a failed IOL as compared to those with normal-BMI.
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