National survey of obstetricians in Wales regarding induction of labour in women with a previous caesarean section

Summary

We conducted a national survey of consultants in Wales to elicit the opinions on induction of labour in women with a previous caesarean section. A total of 65 of the 87 consultants returned the postal questionnaire (75% response rate) and 54 of them were practising obstetricians. All but one obstetrician (53/54) would consider induction and for post-term indication, 47/53 would offer induction to a woman with a previous section; 40/53 (75%) of obstetricians would consider the prostaglandin method. The majority (36/40) would use prostaglandin tablets/gel; 80% (29/36) would use up to 2 doses (maximum recommended) and two-thirds (36/54) would consider syntocinon for augmentation of labour. A total of 34/54 (63%) consultants felt that Bishop's score would influence their decision to offer induction of labour (IOL) in a woman with one previous section and some 88% (47/53) of obstetricians always mentioned the increased risk of caesarean section and uterine rupture to these women during counselling before offer of induction. In conclusion, our survey reveals the variation in approach to management of postdates in women with previous caesarean section. We recommend a national audit of induction of labour in women with previous caesarean section.

Keywords:

• Induction
• previous caesarean
• survey