Abstract:
OBJECTIVE : To determine predictors of outcome for induction of labour using
oral misoprostol. SETTING : Labour ward at Kalafong Hospital in Atteridgeville, Pretoria,
that serves an indigent South African urban population. METHODS : Data were collected
prospectively on all women undergoing induction of labour with oral misoprostol from 1 March 2004 to
28 February 2005. Patients with contraindications to misoprostol induction were excluded. Univariate
analysis and logistical regression analysis were performed to determine the significant predictors
of success of induction of labour. Successful induction was defined as a vaginal delivery achieved
within 24 hours. RESULTS : Five hundred and fifty-eight patients were included. There
were three major indications for induction of labour, namely hypertension (45%), postdates (22.1%)
and prelabour rupture of membranes (20.6%). Vaginal delivery was achieved within 24 hours in 52.4%
of patients. The caesarean section rate was 42.1%. Fetal heart rate changes occurred in 25.6% and
hyperstimulation in 1.4% of patients. Logistical regression analysis identified the following
parameters as independent predictors of vaginal delivery achieved within 24 hours: primiparity
(p < 0.001), Bishop score < 3 (p < 0.001), Bishop score 4 - 6 (p = 0.029),
ruptured membranes (p < 0.001) and pre-eclampsia (p = 0.006). A method of scoring
(Mbele score) has been developed making use of the results of this analysis in order to predict the
successful outcome of induction.Conclusions. Primigravidity, intact membranes,
pre-eclampsia and a low Bishop score were indicators of an unsuccessful outcome for induction of
labour. It is thought that the Mbele score will be helpful in counselling patients on methods of
delivery when they are admitted for induction of labour.
