Induction of labor with oxytocin: indications and determinants of success at the Brazzaville university hospital center.

Abstract

  Introduction. The present study set itself the objectives of listing the indications for the induction of labor with Oxytocin and identifying the determinants of its success at the Brazzaville University Hospital Center. Patients and method. Single-center retrospective cohort study carried out from January 1 to December 31, 2022, including, after a simple random selection without replacement, births between 28 and 43 weeks of amenorrhea whose labor was triggered exclusively with Oxytocin, whatever the Bishop score and membrane condition. They were divided according to the trigger result into two groups: success and 
failure. Induction was successful in the event of induction of two uterine contractions of at least 20 seconds in 10 minutes, associated with effacement of the cervix. The variables studied were sociodemographic and reproductive, clinical and therapeutic. SPSS version 23 software was used for statistical analysis. The p value of the probability was considered significant for a value < 5% Results. Successful induction of labor was noted in 198 cases, or 70.7% of inductions exclusively with Oxytocin (n=280) and failure in the remaining 29.3% (n=82). The indications were dominated by premature rupture of membranes (37.5%; n=105), hypertensive diseases (33.2%; n=93) and overdue term (20.4%; n=57). No significant difference was noted among those who gave birth in terms of age (30.5 years [26 – 34.7] vs 30 years [25.5 – 33]; p=0.05) and reproductive characteristics (p = 0.05). The births having been successfully induced were mainly pauciparous (52% vs 36.6%; OR=3[1.08-8.59]; p<0.05) with a favorable Bishop score (97.5% vs 61%; OR=24.7[9.1-66.6]; p<0.05). Conclusion. The success of inducing labor with Oxytocin is influenced by parity and pre-existing cervical 
changes. The decision to trigger with oxytocin must consider the maturity of the cervix, previously assessed by the Bishop score.