International Journal of Clinical Obstetrics and Gynaecology

Background: Induction of labour (IOL) is common in modern obstetrics. Evidence about how IOL affects maternal and neonatal outcomes compared with spontaneous labour in low-risk primigravidae have been included. This study compares maternal outcomes, delivery complications and neonatal outcomes between term primigravidae with spontaneous onset of labour and those who underwent induction.

Methods: Prospective comparative observational study included 150 primigravidae at term (?37 and <42 weeks) conducted at Department of Obstetrics & Gynaecology, Sylhet MAG Osmani Medical College Hospital, Sylhet, Bangladesh from January 2021 to December 2021. Patients were allocated into two groups: spontaneous labour (Group S, n = 75) and induced labour (Group I, n = 75). Inclusion: singleton cephalic primigravida, term, no major obstetric or medical comorbidity. Exclusion: multiple pregnancy, malpresentation, prior uterine surgery, fetal anomaly, preterm labour. Primary outcomes: mode of delivery (vaginal, instrumental, caesarean). Secondary outcomes: labour augmentation, uterine hyperstimulation, postpartum hemorrhage (PPH), chorioamnionitis, Apgar scores, NICU admission, meconium-stained liquor, perinatal mortality. Statistical analysis used Student’s t-test for continuous variables and ?²/Fisher exact for categorical variables; p < 0.05 considered significant.

Results: Groups were comparable in age and BMI. Mean age: Group S 24.8±3.2 years; Group I 25.6±3.8 years (p = 0.12). Cesarean delivery rates: Group S 12/75 (16.0%) vs Group I 20/75 (26.7%), p = 0.12. Instrumental delivery: 5 (6.7%) vs 8 (10.7%), p = 0.34. Uterine hyperstimulation occurred more in Group I: 6 (8.0%) vs 1 (1.3%), p = 0.05. Oxytocin augmentation was required more often in the induced group (54/75, 72.0% vs 28/75, 37.3%; p < 0.001). PPH (>500 ml): 3 (4.0%) vs 6 (8.0%), p = 0.28. Meconium-stained liquor: 8 (10.7%) vs 14 (18.7%), p = 0.14. NICU admissions: 5 (6.7%) vs 9 (12.0%), p = 0.21. Low 5-minute Apgar (<7): 3 (4.0%) vs 5 (6.7%), p = 0.47. Perinatal deaths: 0 vs 1 (1.3%), p = 0.31.

Conclusions: In this cohort of 150 term primigravidae, induction of labour was associated with significantly higher rates of uterine hyperstimulation and need for oxytocin augmentation, while differences in cesarean, PPH, neonatal outcomes and NICU admission did not reach statistical significance. Induction should be individualized with careful monitoring and readiness to manage hyperstimulation and fetal compromise.