Medication-induced labor with prostaglandins in viable fetuses: a 31-month retrospective study in the gynecology and obstetrics department of Amath Dansokho hospital/Kédougou/Senegal

Background: To analyze the indications, methods, and outcomes of labor induction with prostaglandins at the Gynecology and Obstetrics Department of Amath Dansokho Regional Hospital in Kédougou, Senegal. Methods: We conducted a retrospective cohort study including 2,750 deliveries from January 1, 2023, to July 31, 2025. All pregnant women ≥28 weeks receiving prostaglandin-induced labor were included (n=501). Exclusion criteria were intrauterine fetal death, abnormal fetal heart rate on admission, prophylactic cesarean, and incomplete records. Data on sociodemographic, obstetric history, induction indications, induction method, and maternal and neonatal outcomes were analyzed using SPSS 27. Patients were classified as “Exposed” (induced) and “Unexposed” (spontaneous labor). Results: Labor induction frequency was 18.2%. Main indications were post-term pregnancy (29.4%), hypertensive disorders (28.9%), and preventive induction (19.3%). Misoprostol (91.6%) was the primary induction agent, administered vaginally at 25 µg per dose. Induction success was 97.6%. Vaginal delivery occurred in 85% of induced patients, and cesarean section risk was significantly lower compared to spontaneous labor (14.8% vs. 25.9%; RR=0.57, p<0.001). Uterine rupture occurred in 0.6% of cases. Neonatal outcomes, including Apgar score <7 at 5 minutes, neonatal resuscitation, transfer, and stillbirth, did not differ significantly between groups. Conclusions: Labor induction with prostaglandins is a safe and effective strategy in a resource-limited and geographically isolated setting, reducing cesarean section rates without compromising neonatal outcomes. Preventive induction and structured monitoring protocols are practical approaches to improve maternal and neonatal safety in low-resource contexts. These findings support the use of context-specific guidelines and further research on optimal induction protocols in similar settings.