Predicting factors of failed induction of labor in three hospitals of Southwest Ethiopia: a cross-sectional study

Abstract

Abstract Introduction Failed induction of labor affects maternal and neonatal outcomes as well as the cost of healthcare, especially in low-resource setting regions in which the prevalence of failed induction is higher despite the incidence of labor induction is low. This study aimed to assess the prevalence of failed induction of labor in southwest Ethiopia. Method A hospital-based cross-sectional study was conducted among 441 induced women from March 1 to August 30, 2018. A systematic random sampling technique was used to select study participants. Data were collected using a pretested and structured questionnaire. Bivariable and multivariable logistic regression models were done and fitted to identify predictors of failed induction. An adjusted odds ratio with 95% confidence interval (CI) was calculated to determine the level of significance. Result Premature rupture of membrane was the most common cause of labor induction and the commonly used method of labor induction were oxytocin infusion. Cesarean section was done for 28.1% of induced women. Failed induction of labor was found to be 21%. Primiparous [AOR = 2.35 (1.35–4.09)], analgesia/anesthesia [AOR = 4.37 (1.31–14.59)], poor Bishop Score [AOR = 2.37 (1.16–4.84)], Birth weight ≥ 4 k grams [AOR = 2.12 (1.05–4.28)] and body mass index [AOR = 5.71 (3.26–10.01)] were found to be significantly associated with failed induction of labor. Conclusion The prevalence of failed induction of labour was found to be high. Preparation of the cervix before induction in primi-parity women is suggested to improve the success of induction. To achieve the normal weight of women and newborns, proper nutritional interventions should be given for women of reproductive age. It is better to use analgesia/anesthesia for labor induction when it becomes mandatory and there are no other optional methods of no- pharmacologic pain management.