A RANDOMIZED COMPARATIVE STUDY OF PROGRESS OF LABOUR AND FETAL OUTCOME OF DELIVERY AMONGST SPONTANEOUS VERSUS INDUCED LABOUR IN TERM PREGNANCY PRIMI GRAVIDA OF USING MODIFIED WHO PARTOGRAPH IN THE DEPARTMENT OF OBSTETRICS AND GYNECOLOGY SMS MEDICAL COLLEG

Abstract

Background: Childbirth is the period from the onset of regular uterine contraction until expulsion of placenta. The process by which this normally occurs is called labour. Induction of labour is the artificial initiation of uterine contraction prior to their spontaneous onset, leading to progressive dilatation and effacement of the cervix and delivery of the baby. Labour induction is indicated where the benefits to either the mother or the fetus outweighs the benefit of continuing pregnancy.

Methods: Hospital based Prospective type of cross sectional study conducted at Department of Obstetrics and Gynaecology, S.M.S Medical College, Jaipur, Rajasthan. We assessed the following perinatal outcomes: at 1^st and 5^th minute APGAR score; birth weight; birth injuries; respiratory distress syndrome; admission to the  NICU; number of days in NICU; neonatal deaths taking place in hospital within the first week of life; stillbirth or intrauterine death.

Results: The highest percentage of babies were in the weight category of 2500 to 3499 grams in both groups, 83.3% in spontaneous and 76.7% in induced group, followed by ?3500 gram and <2500 gram  respectively. There is no statistical significant difference in weight of babies between the groups (P=0.64). In induced group ?7 APGAR Score at 1 minute is 1.1%, and 7.8% in spontaneous group. There is statistically significant increase in Spontaneous group (P < 0.05). In induced group ?7 Apgar score at 5 minutes is 0%, and 5.6% in spontaneous group. ?7 APGAR score at 5minutes is significantly higher in Spontaneous group (P < 0.05). 3.3% of Induced group babies needed Admission to NICU compared to 2.2% in Spontaneous group, there is no statistically significant difference between groups (P = 0.684)

Conclusion: We conclude from this study that though requirement of Augmentation for progress of Labour was more in induced group and Instrumentation rate of Caesarean section was also high in induced group. But the Neonatal outcome of Labour if monitored with modified WHO Partograph is less than Spontaneous group and also duration of labour is shorter in induced labour.

Keywords: WHO Partograph, Induction, Neonatal outcome.