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Prospective cohort study of induction of labor: Indications, outcome and postpartum hemorrhage

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INTRODUCTION This study was undertaken because of the increasing rate of induction
of labor (IOL) in our hospital and its associated higher caesarean section (CS) rates.
The objective was to ascertain the incidence, indications, methods, outcome, and
complications of IOL, in particular postpartum hemorrhage.
METHODS This was a prospective observational cohort study of women who underwent IOL
in a medium-sized district general hospital. Blood loss was measured by the gravimetric
method and correlated to postpartum hemoglobin level within 48 hours of birth.
RESULTS A total of 445 women needed IOL (incidence 33%). Common indications were:
small for gestational age (SGA) or fetal growth restriction (FGR) (18%), spontaneous
rupture of membrane (17%), reduced fetal movement (16%), prolonged pregnancy (15%),
and diabetes (13%). In all, 67% women achieved spontaneous vaginal delivery and 18%
underwent caesarean section. With regard to blood loss, 62 women (14%) had postpartum
hemorrhage (PPH) of >1000 mL and 22 women (4.9%) had a blood loss >1500 mL. The
caesarean section rate was higher than the overall emergency caesarean section rate in
that year. Incidence of PPH in this cohort was higher than the normal incidence.
CONCLUSIONS Increasing trend of induction of labor (IOL) is due to the changing clinical
policy on management of small for gestational age babies, spontaneous rupture of
membrane, reduced fetal movement and other complications of pregnancy. There is
conflicting evidence on the effect of IOL on caesarean section rates. IOL is a risk factor for
PPH. Accurate measurement of blood loss is essential in detecting a fall in hemoglobin
which in turn helps in the appropriate management of PPH.

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Informasi Detail

Judul Seri

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No. Panggil

618.2

Penerbit

Heraklion, Crete, Greece : EU European Publishing., 2021

Deskripsi Fisik

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Bahasa

English

ISBN/ISSN

2585-2906

Klasifikasi

618.2

Tipe Isi

text

Tipe Media

unspecified

Tipe Pembawa

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Edisi

-

Subjek

kebidanan
Midwifery

Info Detail Spesifik

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Pernyataan Tanggungjawab

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Versi lain/terkait

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