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Abstract
Objective
Comparison between the frequency of emergency cesarean section in cases of induction of labor and spontaneous labor in primigravida females.
Methodology
The comparative cross-sectional study was carried out in the department of obstetrics and gynecology, Saidu teaching hospital, Swat, Pakistan, from October 2023 to April 2024.. Three hundred thirty-eight primigravida females with age ranging from 18-40 years old having singleton pregnancies and gestational age between 37-40 completed weeks were taken as sample size in the study. Using non-probability consecutive sampling technique, patients were equally divided into two groups such as induction of labor (n=169) and spontaneous labor (n=169).
All demographic data, obstetric data, and delivery results were recorded by using the structured proforma. The main outcome variable was emergency cesarean section. Statistical analysis was performed using SPSS 24 version software. Mean and standard deviations were used to present continuous data. Whereas frequency and percentage were used to present categorical data. Comparison was done between two groups using chi-square test, p-value less than or equal to 0.05 was considered statistically significant.
Results
Three hundred thirty-eight women were included in this study and 169 participants in each group. The mean age of the subjects was 27.8 ± 4.8 years. Seventy-seven females (22.8%) underwent emergency cesarean section. The emergency cesarean delivery rate was found to be significantly higher in induction group than the spontaneous labor group [54 (31.9%) vs. 23 (13.6%); p<0.001]. Labor induction increased the chance of emergency cesarean delivery almost three times (OR=2.98). The postdated pregnancy was the commonest reason for induction (36.1%) and fetal distress was the commonest reason for emergency cesarean delivery (37.7%). Increased rate of cesarean section was observed among obese patients and patients without adequate antenatal care.
Conclusion
Induction of labor resulted in significantly higher rate of emergency cesarean section among primigravida women compared to spontaneous labor. Further increase in risk of delivery was noted among obese and those with inadequate antenatal care.