Introducing a Modified Grenoble Classification for induction of labour with an audit at a regional maternity unit in...

Rates of induction of labour (IOL) have dramatically risen in recent years. Currently no universally adopted classification system for IOLs exists. A comprehensive classification system would enable analyses of trends and benchmarking of practices. A previously proposed classification attempted to address this issue, but it did not appear to be fully comprehensive, as it did not account for IOL for preterm prelabour rupture of membranes. Furthermore, without subcategorization to reflect some common indications the utility of the classification system is limited. We have aimed to create a Modified Grenoble Classification that is inclusive of all IOL indications and then explored the feasibility of implementing this system at our institution, a regional hospital in Queensland, Australia.

We conducted a retrospective audit using routinely collected information for all women undergoing IOL at our facility across a two-year period (n = 1663). Cases were classified into one of eight groups, with the IOL for maternal or fetal pathology group further subcategorised by some common indications. Percentage of total IOLs were calculated for each group.

The new classification was simple to implement at our institution. The largest groups consisted of IOL for maternal or fetal indication (67.6 %), post-dates gestation (15.0 %), and term prelabour rupture of membranes (9.5 %).

To our knowledge, this is the first paper describing the implementation of a classification system for IOL that is inclusive of all indications. We suggest this is a utile tool to allow analysis of IOL practices.