Mode of delivery of labour induction in nulliparous women with singleton term pregnancy and cephalic presentation - In 5-year period

Introduction and aims of the study: Induction of labour (IL) is a common obstetric procedure, but it is questionable whether it results in higher Caesarean section (CS) rates. The aim of the study is to evaluate the mode of the delivery of labour induction in nulliparous women with singleton term pregnancy and cephalic presentation and its contribution to the overall rate of CS. Methods: A retrospective study was contacted that included nulliparous women with singleton term pregnancy and cephalic presentation whose labour was induced in the secondary perinatal care centre (Riga Maternity Hospital, Latvia) from 2018 to 2022. Results: In total, in the study 4183 women (2018–608, 2019–795, 2020–812, 2021–989, 2022–979) were included. During the 5-year period, the study group made from 10.2% in 2018 to 19.3% in 2022 (2019-13.6%, 2020-15.2%, 2021-17.2%) of all deliveries. Although the CS rate of the study group has decreased from 30.4% in 2018 to 21.6% in 2022 (2019-24.9%, 2020-25.0%, 2021-24.4%), the absolute contribution of the group to the overall CS rate has increased from 3.1% in 2018 to 4.2 % in 2022. The operative vaginal delivery rate has increased (2018–6.1%, 2019–11.1%, 2020–14.2%, 2021–13.1%, 2022–16.6%). During this period, the induction method was changed. At the beginning of the period (2018, 2019), it was Misoprostol orally. The combined method (transcervical Foley catheter and Misoprostol orally) was introduced in 2020 and was used during 2022 for all pregnant women without prostaglandin contraindications. Conclusions: Analysis of the group of specific patients allows a detailed understanding of the mode of delivery, and the absolute contribution of the group to the overall rate of CS and the creation of a focused strategy for its reduction in specific groups of patients.