Outcome of mechanical mode of induction in failed primary labor induction

To determine the role of an alternate (mechanical) inducing agent in failed labor induction.

Quasi-experimental study.

Labor Ward at Mother and Child Health Center (MCH), Pakistan Institute of Medical Sciences (PIMS) from May 1999 to July 2003.

Women with singleton term gestation and normal live fetus undergoing indicated induction of labor were included if Bishop score was < or = 5 after 12-18 hours of primary induction with PGE2 vaginal tablets. They were then induced with mechanical method i.e. intracervical foley catheter, if fetal status was reassuring and no evidence of labor onset. The main outcome measure was mode of delivery. Secondary outcome measures were induction labor interval and induction delivery interval after second mode of induction and neonatal Apgar score.

Thirty-six women received a second mode of induction for failed induction. Four patients were excluded. Of 32 eligible women, 24 (75%) delivered vaginally. Eight patients (25%) had emergency caesarean section. Mean induction labor interval after second mode of induction was 6.8 hours and mean induction delivery interval was 12.39 hours. Mean Apgar score at 1 minute and 5 minutes was similar in both vaginal deliveries and caesarean sections.

When an alternate mechanical method was used, 75% of women labeled as "failed induction" delivered vaginally.