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To determine the outcome of induction of labor, specifically incidence of uterine rupture and reliable predictors of repeat caesarean delivery, in women undergoing induction of labor after previous caesarean section.A review of obstetric and perinatal records of 167 women who had their labor induced after one transverse lower uterine incision performed at previous caesarean delivery in a referral tertiary hospital in Nigeria between January 2006 and December 2009.The incidence of uterine rupture was 2.4%. Independent risk factors for repeat caesarean delivery were absence of prior vaginal delivery (OR 3.7; 95% CI 1.9-7.1), duration of latent phase2 h (OR 4.3; 95% CI 1.7-11.2), postdated pregnancy (OR 2.2; 95% CI 1.1-4.0) and previous caesarean for non-recurrent indication (OR 2.1; 95% CI 1.1-4.0).Choice of appropriate delivery option for this cohort of women based on the identified risk factors is essential to minimize the incidence of failed vaginal birth and its associated adverse maternal and neonatal outcome.

To determine the incidence of ruptured uterus as well as the clinical profile and management options in a tertiary hospital setting.Thirty-three cases of ruptured uterus managed at University of Benin Teaching Hospital (UBTH) from 1 January 2003 to 31 December 2007 were identified and retrospectively studied.The incidence of ruptured uterus was 4.2 per 1000 deliveries (0.4%). Majority (87.9%) of the patients were unbooked. Injudicious use of oxytocics (63.7%) and prolonged obstructed labor (60.6%) were the main associated risk factors. All 33 patients had laparotomy and 51.2% had repair of the uterine rupture only. The type of surgery performed was influenced by the site and extent of rupture. There were two cases of maternal deaths in this study, giving a case fatality rate of 6.1%.Rupture of the gravid uterus is still a problem in Nigeria. A proactive approach to preventing prolonged obstructed labor and curbing the injudicious use of oxytocics through education and utilization of modern antenatal and intrapartum care is advocated.

To determine the outcome of labor induction with intravaginal misoprostol among women with perception of persistent decrease in fetal movements at term.The study group comprising 107 women who had induction of labor at term for primary complaint of decreased fetal movements (DFM) were compared with equal number of women who had induction for prolong pregnancy in a university teaching hospital.Caesarean section rate (39.3% vs. 22.4%, P0.001) and birthweight less than 2500 g (11.2% vs. 2.8%, P = 0.02) were significantly higher in the DFM group with the leading indication for caesarean delivery being nonreassuring fetal heart rate. Also, the incidence of 5-min Apgar score7 were significantly lower among women in the DFM group. However, there was no difference in neonatal unit admission. There was no case of early neonatal death in both groups of women.Intravaginal misoprostol for labor induction is a safe delivery option for women with perception of DFM with reassuring nonstress test. Since all cases with persistent decrease in fetal movements had reassuring nonstress test, the reduction in fetal movements was most likely due to altered perception.

The objective of this study was to determine why parturients in a low resource setting fail to keep an appointment for induction of labour and evaluate the subsequent pregnancy outcome. The method used was a prospective matched case control study. Results showed that women with only primary school education were significantly more common in the study group (8% vs 1%; p0.05). The main reason for failing to keep the appointment was because they preferred spontaneous onset of labour (56.6%) and the 'spousal factor' (23.9%). Patients who were counselled by the consultant obstetrician were less likely to decline compared with those counselled by the resident doctors. Although the pregnancy outcome was comparable, failed induction of labour leading to caesarean section was significantly commoner among the study group (p0.05). It was concluded that social and cultural factors affecting the utilisation of health services should be considered by obstetric care providers in developing countries, to promote safe motherhood.

To document the experience with social induction of labour (IOL) and compare its outcome with electively induced labour for prolonged pregnancy. A prospective matched case–control study. Social IOL was significantly common in women of high social class (78.3 vs. 45.6%, P = 0.03) and the commonest indication was because the parturient was ‘tired of pregnancy’ (60.9%). There was no significant difference between both groups in the mean induction to delivery interval, caesarean section and instrumental delivery rates, 5-minute Apgar score