Perinatal and Maternal Outcomes of Induction of Labour Using Oral Misoprostol in Premature Rupture of Membranes at Hoima Regional Referral Hospital, Uganda
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Date
2020-01
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Kampala International University
Abstract
Background: Premature rupture of membranes (PROM) is among the most common causes of maternal and perinatal morbidity and mortality. This could be due to an increase in the latent period from rupture of membranes to delivery interval. Some of the complications of PROM included maternal or perinatal infections that could be prevented by induction of labor using effective methods such as oral misoprostol administration. However, the perinatal and maternal outcomes following such intervention had not been well studied in our setting.
Objectives: To determine the perinatal and maternal outcomes of induction of labour (IOL) using low dose oral misoprostol (25μg/25ml) solution in premature rupture of membranes at Hoima Regional Referral Hospital, Uganda.
Research methods and materials: This was a longitudinal study which was conducted among pregnant women at term with PROM admitted in maternity ward at Hoima Regional Referral Hospital from February to April, 2019. 78 pregnant women were enrolled to the study. Structured pretested questionnaires and partographs were used to collect maternal and perinatal variables including the outcomes. The data obtained was entered in Microsoft excel version 2010, then imported into STATA 15.0 (Statacorp, USA Texas) for analysis.
Results: Majority of participants 97.9% in misoprostol 86.7% in oxytocin delivered vaginally with mean IDI significantly less in misoprostol group (p=<0.001) 18.7±5.2 hours. The overall good maternal outcome was 80% in oxytocin and 75% in misoprostol and the significant poor outcomes included 13.3% caesarean section in oxytocin and 20.8% perineal tears occurred in misoprostol (p=0.038). Both groups had normal birth weights with the 5th minute Apgar score of >7 97.9% in misoprostol and 93.3% in oxytocin groups. Foetal distress (4.2%), meconium passage (4.2%) and NICU admissions 14.6% were more in misoprostol group while more neonatal sepsis 20% and 1 neonatal death occurred in the oxytocin group.
Conclusion: Oral misoprostol had significantly reduced mean induction to delivery interval and increased perineal tears while oxytocin had significant increase caesarean delivery. Oral misoprostol and intravenous oxytocin had equally good foetal outcomes. Oral misoprostol and oxytocin had comparable neonatal outcomes.