• Syeda Batool Mazhar and Kausar Jabeen.
• Mother and Child Health Center, Pakistan Institute of Medical Sciences, Islamabad, Pakistan. batool@isb.comsats.net.pk
• J Coll Physicians Surg Pak. 2005 Oct 1; 15 (10): 616-9.

ObjectiveTo determine the role of an alternate (mechanical) inducing agent in failed labor induction.DesignQuasi-experimental study.Place And Duration Of StudyLabor Ward at Mother and Child Health Center (MCH), Pakistan Institute of Medical Sciences (PIMS) from May 1999 to July 2003.Patients And MethodsWomen with singleton term gestation and normal live fetus undergoing indicated induction of labor were included if Bishop score was < or = 5 after 12-18 hours of primary induction with PGE2 vaginal tablets. They were then induced with mechanical method i.e. intracervical foley catheter, if fetal status was reassuring and no evidence of labor onset. The main outcome measure was mode of delivery. Secondary outcome measures were induction labor interval and induction delivery interval after second mode of induction and neonatal Apgar score.ResultsThirty-six women received a second mode of induction for failed induction. Four patients were excluded. Of 32 eligible women, 24 (75%) delivered vaginally. Eight patients (25%) had emergency caesarean section. Mean induction labor interval after second mode of induction was 6.8 hours and mean induction delivery interval was 12.39 hours. Mean Apgar score at 1 minute and 5 minutes was similar in both vaginal deliveries and caesarean sections.ConclusionWhen an alternate mechanical method was used, 75% of women labeled as "failed induction" delivered vaginally.

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