الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Summary and Conclusion
I
nduction of labor is one of the most common clinical scenarios that require great obstetric clinical sense as regards the suitability of management protocol particularly in multiparous cases to avoid unnecessary cesarean section delivery mode.
Misoprostol a commonly used agent for induction of labor have raised issues of concern as regards its best dosage and safety on triggering the physiological process of labor.
In the current research study 253 research study were investigated for eligibility from them 103 cases were excluded (91 cases didn’t meet the research inclusive criteria,12 cases refused participation the remaining 150 cases were randomized into two equal numbered research groups (induction and spontaneous research groups).as regards the induction research group all study subjects were statistically analyzed and have undergone elective induction 69 cases delivered vaginally and 6 cases have delivered by cesarean section, whereas the spontaneous onset research group had 3 cases lost in follow-up and the remaining 72 cases left for analysis have been cases gone through spontaneous onset from them 59 cases were delivered vaginally and 4 cases were delivered by cesarean section whilst 9 cases have gone through selective induction 5 of them delivered vaginally and 4 cases delivered by cesarean section.
Cesarean section was statistically significantly most frequent in selective induction research group (p value = 0.001) with no statistical significant difference between elective induction and spontaneous onset research groups interestingly it was revealed as regards the value of elective induction over selective induction that the rate of elevation = 36.4%, efficacy =65.6%, relative rate =1.66, number needed to treat =2.7.
Those research findings denote that elective induction management protocol is a valuable management line in reducing cesarean section rates although some sudden clinical scenarios such as spontaneous rupture of membranes may affect the efficacy of labor induction management causing more cesarean section deliveries particularly among post term.
In conclusion, this randomized clinical trial reports that induction of labor in multiparous women at 39 weeks is a safe option for both mother and foetus with no increase in caesarean section rate or foetal unfavourable outcomes and so it can be considered especially for women seeking scheduled delivery