Premium
Factors associated with delayed onset of active labor following vaginal misoprostol administration among women at Mbarara Regional Referral Hospital, Uganda
Author(s) -
Kajabwangu Rogers,
Bajunirwe Francis,
Lukabwe Henry,
Atukunda Esther,
Mugisha Dale,
Lugobe Henry M.,
Nakalinzi Joanita,
Mugyenyi Godfrey R.
Publication year - 2021
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.13402
Subject(s) - medicine , misoprostol , obstetrics , labor induction , relative risk , prospective cohort study , gestation , body mass index , confidence interval , gestational age , pregnancy , gynecology , abortion , oxytocin , surgery , genetics , biology
Objective To determine the factors associated with delayed onset of active labor following labor induction with vaginal misoprostol. Methods We conducted a prospective cohort study over 6 months at a tertiary hospital in Uganda. We enrolled mothers with pregnancies of at least 28 weeks, who were undergoing labor induction with 50 µg of vaginal misoprostol, administered every 6 hours with a maximum of four doses, and followed them up until onset of active labor. Labor onset was considered delayed if it occurred later than 12 hours after the first dose. Bivariate and multivariate analysis was performed to determine factors associated with delayed onset of active labor. Results Of the 88 mothers enrolled, 22.7% (n=20) had delayed onset of active labor. Nulliparity (adjusted relative risk [aRR] 2.34, 95% confidence interval [CI] 1.17–4.68) and gestational age less than 37 weeks (aRR 3.79, 95% CI 1.40–10.23) were associated with delayed onset of active labor following vaginal misoprostol administration whereas higher body mass index (aRR 0.38, 95% CI 0.18–0.79) decreased the risk. Conclusion Delayed onset of active labor following labor induction remains an important obstetric care challenge. Mothers undergoing labor induction should have their body mass index documented, and nulliparous women and mothers at less than 37 weeks of gestation should have their labor monitored for a longer duration following labor induction.