Comparative analysis of preinduction cervical ripening and induction of labour in a Polish and German hospital

Introduction: The aim of preinduction is to accelerate cervical ripening, which results in a reduction in the number of cesarean deliveries and unsuccessful inductions, and shortens the hospitalization time for both women and infants. Induction of labour is an obstetric procedure which involves the stimulation of contractions prior to the spontaneous onset of labour.

Materials and methods: The research was conducted retrospectively and involved the analysis of medical records of 80 pregnant women staying in the Clinic of Obstetrics and Gynecology in the city of Szczecin, Poland, and 117 pregnant women hospitalized in the Clinic of Obstetrics and Gynecology in the town of Schwedt/Oder, Germany.

Results: The most common indications for preinduction cervical ripening and induction of labour in the Polish and German hospitals were oligohydramnios, macrosomia, suspected placental insufficiency, pregnancy between 41 + 0 and 41 + 6 weeks of gestation, intrauterine growth restriction and premature rupture of the membranes. The main indications for preinduction cervical ripening and induction of labour included premature rupture of the membranes (Polish hospital) and pregnancy between 41 + 0 and 41 + 6 weeks of pregnancy (German hospital).

In the German hospital, there were more cases of preinduction and induction resulting in vaginal delivery – 85.47%, whereas in the Polish hospital the percentage was lower at 68.75%. The number of cesarean deliveries was substantially higher in the Polish hospital (31.25%) than in the German hospital (14.53%).

In the Polish hospital, the average duration from the moment of applying a method to the onset of regular contractions was 113 min shorter than in the German hospital. The average duration of vaginal delivery for women in the German hospital, totalled 236 min, which was 42 min shorter than for women at the Polish hospital. The largest percentage of scores on the Apgar scale at the first, third and fifth min after birth was within the normal range and indicated good health conditions of infants with scores ranging from 8–10 points in both hospitals. Significantly more infants in the German hospital received pH from the umbilical cord within the limits of the norm which marks the welfare of neonates (7.20–7.45). The average change in the evaluation of the cervix marked in the Bishop score was higher in the German hospital, making 3.2 points, compared to 0.7 points in the Polish hospital. The duration of hospitalisation in the Polish hospital was shorter than that in the German hospital (3.4 days, with a median of 3 days). The number of days of preinduction and induction was shorter in Poland (1.2 day). The levels of haemoglobin were comparable in the case of the patients from both hospitals.

Among the postpartum complications, cervical rupture and episiotomy were significantly more common in the Polish hospital, while second-degree rupture of the perineum in the German hospital.