AFJOG

African Journal of Obstetrics and Gynaecology | Volume 3 | Issue 2 | 2025 | 23 ORIGINAL RESEARCH African Journal of Obstetrics and Gynaecology | Volume 3 | Issue 2 | 2025 | Birth outcomes of primigravid women augmented with oxytocin in two regional hospitals: A comparison of gradual vs accelerated regimen IOL: induction of labour; NVD: normal vaginal delivery; CS: caesarean section Baseline characteristics of the study participants At RKK, the mean (SD) age was 22.5 (5.1) years, BMI 28.4 (6.5) kg/m 2 , and gestational age at delivery 39.5 (1.2) weeks. At HGRH, these values were 22.7 (5.1) years, 30.7 (6.9) kg/m 2 , and 39.1 (3.2) weeks, respectively. No significant differences were found in these characteristics between the centres (Table 2). Table 2: Participant characteristics at RKK andHGR Hospitals Characteristics RKK Hospital (n = 56) HGR Hospital (n = 40) p-value Age (years), mean (SD) 22.5 (5.1) 22.7 (5.1) 0.85 BMI (kg/m2), mean (SD) 28.4 (6.5) 30.7 (6.9) 0.09 Gestational age at delivery (weeks), mean (SD) 39.5 (1.2) 39.1 (3.2) 0.40 Comparison of accelerated and gradual regimens Overall, successful vaginal delivery was achieved in 36.5% (35/96) of patients for both regimens, with no significant difference between the accelerated and gradual regimens (p = 0.28). The C-section rate was 60.7% (34/56) for the accelerated dose and 67.5% (27/40) for the gradual regimen. The mean interval from augmentation commencement to delivery was significantly shorter in the accelerated regimen (2.9 hours) compared to the gradual regimen (5.0 hours); p<0.001, inclusive of both vaginal and C-section deliveries. For vaginal deliveries, the mean (SD) birth weight was significantly lower at HGRH (gradual regimen) than at RKK (accelerated regimen); 3 148 (432.6) g versus 3 334 (428.1) g, respectively (p = 0.04). Pethidine use was significantly higher at RKK (accelerated dose) compared to HGRH (gradual dose); 92.9% (52/56) versus 52.5% (21/40), p = 0.0013. No significant differences were observed in mean cervical dilatation at the onset of augmentation, mean maximum oxytocin dose reached, C-section indications, mean birthweight for C-section deliveries, and mean APGAR scores, between the regimens. (Table 3). Table 3: Clinical parameters comparison by regimen received (accelerated vs. gradual) Clinical Parameters Accelerated Regimen (n = 56) Gradual Regimen (n = 40) p-value Cervical dilatation at onset of augmentation (cm), mean (SD) 4.9 (1.2) 4.9 (1.09) 0.82 Maximum dose of oxytocin reached (mU/ min), mean (SD) 13.3 (6.1) 12.7 (6.2) 0.64 Successful vaginal delivery 22 (39.3) 13 (32.5) 0.28 Interval from augmentation commencement to successful delivery (hours), mean (SD) 2.9 (1.9) 5.0 (2.8) <0.001 C-section Delivery, n (%) 34 (60.7) 27 (67.5) 0.10 Poor Progress, n (%) 17 (50) 17 (62.9) 0.16 Suboptimal CTG, n (%) 17 (50) 9 (33.3) 0.85 Other, n (%) 0 1 (3.7) - Birth Weight (NVD), mean (SD) 3 147.9 (432.6) 3 333.8 (428.1) 0.04 Birth Weight (CS), mean (SD) 3 212.1 (432.9) 3 418.9 (424.1) 0.066 APGAR Score, mean (SD) 8.6 (0.8) 8.6 (0.7) 0.97 Analgesic use Pethidine 52 (92.9) 21 (52.5) 0.0013 Combination (Pethidine + Entonox) - 6 (15) - Maternal and foetal characteristics across different deliverymodes A comparative analysis of maternal and foetal characteristics across different modes of deliverywas conducted at twomedical centres. In the gradual dose centre, the highest C-section rates were observed in women with a BMI of 30-34.99 (88.9%) and 35-39.99 (90%); p = 0.022. Conversely, no significant differences were observed in BMI and modes of delivery in the accelerated dose centre. Maternal age and birth weights did not significantly differ between modes of delivery at both centres (Table 4). Table 4: Comparison ofmaternal and foetal characteristics across different modes of delivery in two centres Maternal and foetal characteristics Accelerated dose (RKK) n (%) p- value Gradual dose (HGRH) n (%) p- value C-section NVD C-section NVD Maternal age (years) <20yrs 12 (63.2) 7 (36.8) 0.744 10 (76.9) 3 (23.1) 0.345 20-29yrs 17 (56.7) 13 (43.3) 16 (66.7) 8 (33.3) 30-39yrs 5 (71.4) 2 (28.6) 1 (33.3) 2 (66.7) BMI (kg/m2) <18.5 0 (0.0) 1 (100.0) 0.277 - - 0.022 18.5 – 24.99 10 (66.7) 5 (33.3) 4 (33.3) 8 (66.7) 25 – 29.99 10 (47.6) 11 (52.4) 4 (80.0) 1 (20.0) 30 – 34.99 9 (75.0) 3 (25.0) 8 (88.9) 1 (11.1) 35 - 39.99 2 (50.0) 2 (50.0) 9 (90.0) 1 (10.0) ≥ 40 3 (100.0) 0 (0.0) 2 (50.0) 2 (50.0) Birth weight (g) HGRH 872 Files retrieved. 71 Augmented 33 excluded • Incomplete notes (18) • Latent phase of labour (11) • Had IOL (7) 510 Not Augmented 40 enrolled in the study 27 CS (67.5%) 13 NVD (32,5%)