INDICATIONS AND RATE OF CAESAREAN SECTION IN WOMEN WITH INDUCTION OF LABOUR: A CROSS-SECTIONAL STUDY

Background: The increasing use of labour induction in obstetrics has contributed to a global rise in cesarean section (CS) rates. Although induction is a valuable intervention when prolonged pregnancy endangers maternal or fetal health, it has been associated with a higher likelihood of operative delivery. Understanding the relationship between induction and CS is vital to ensure safe obstetric practices and optimal perinatal outcomes. Objective: To determine the indications and rate of cesarean section among women undergoing induction of labour. Methods: This cross-sectional study was conducted in the Department of Obstetrics and Gynecology, Unit II, Fauji Foundation Hospital, Foundation University Islamabad, over six months (September 2, 2023–February 28, 2024). A total of 138 women aged 20–35 years with singleton live pregnancies between 37 and 42 weeks and cephalic presentation were enrolled. Women with prior cesarean sections, malpresentations, uterine anomalies, or multiple pregnancies were excluded. Induction was initiated with prostaglandin E2 (dinoprostone) gel or tablet, and oxytocin infusion was used for augmentation when necessary. Maternal and neonatal outcomes were recorded, including cardiotocography (CTG) findings, Apgar scores, and neonatal intensive care unit (NICU) admissions. Data were analyzed using SPSS version 26, with a p-value <0.05 considered statistically significant. Results: Of the 138 women, 87 (63.0%) were primigravida, and 51 (37.0%) were multigravida. Fetal growth restriction (36.0%) and oligohydramnios (25.9%) were the most frequent indications for induction. Vaginal delivery occurred in 120 women (87.0%), while 18 (13.0%) required cesarean section. Non-reactive CTG was significantly associated with cesarean delivery (p = 0.019). Neonates delivered via CS had higher NICU admissions (27%) compared to vaginal deliveries (20%) (p = 0.002), and a higher proportion had Apgar scores <7 (p = 0.008). Conclusion: Labour induction at term, when performed in well-selected patients under strict monitoring, was associated with a low rate of cesarean sections. Fetal growth restriction and oligohydramnios remained the most common indications for induction, emphasizing the importance of individualized assessment and vigilant intrapartum care to improve maternal and neonatal outcomes.