FREQUENCY OF SUCCESSFUL VAGINAL DELIVERY AFTER INDUCTION OF LABOR IN OBESE AND NON OBESE PRIMIGRAVIDAS

Abstract

Introduction

Obesity has emerged as a major public health problem around the globe over the past two decades. as the overall prevalence of obesity increases so does the number of women of reproductive age who are overweight or obese. The association between maternal obesity, pregnancy and labour outcomes are complex. Emerging evidence suggests obesity is associated with increased complications during pregnancy Local data on frequency of successful vaginal delivery after induction of labour in post-date Obese and Non-Obese Primigravida is very scarce and may be different due to different Geographic, Social, Economic and Environmental factors in our local population.

Objective:

To determine the frequency of successful vaginal delivery after induction of labour in post-date Obese and none Obese primigravida. Setting: Gynecology and Obstetrics Department, Lady Reading Hospital, Peshawar.

Study design: Descriptive cross-sectional study

Duration of study: Six months 03 April, 2019 to 03 October, 2019

Material And Methods: 

170 Patients fulfilling the inclusion criteria from Inpatient Gynecology and Obstetrics Department, Lady Reading Hospital, Peshawar were included in the study after permission from ethical committee and research department. Basic demographics was noted and Informed consent were taken. Inclusion and Exclusion criteria were strictly followed to control the confounding variables. All patients were induced by intracervical PGE2 gel 0.5mg . Reinduction was done after 8 hour of initial induction, in cases of induction failure (inability to achieve cervical dilatation >4 cm), and it was repeated  with third gel if required. Patients were followed for maximum 24 hours. Cesarean delivery were performed in case of fetal distress, non progress of labour and failure of induction with/without chorioamnionitis (Intrapartum temperature >100.4°F or >37.8°C (by thermometer), tachycardia (>120 beats/min), Fetal tachycardia (>160-180 beats/min), Purulent or foul-smelling vaginal discharge and maternal leukocytosis (total blood leukocyte count >15,000-18,000 cells/μL) on laboratory test)for both maternal and fetal well being.

Results: 

In this study mean age was 28 years with SD ± 8.55. All the 170 patients were primigravida. Eighty eight percent patients had POG 41 weeks while 12% patients had 42 weeks. Sixty six percent patients were non obese and 34% patients were obese. More over seventy five percent patients had successful vaginal delivery while 25% patients didn’t had successful vaginal delivery.

Conclusion:
Our study concludes that the frequency of successful vaginal delivery was 75% after induction of labour in post-date primigravida.