{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T03:02:33Z","timestamp":1787022153000,"version":"build-2736575974"},"reference-count":57,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2024,11,15]],"date-time":"2024-11-15T00:00:00Z","timestamp":1731628800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The occurrence of failed induction led to higher rates of health problems and death among mothers, mainly as a result of complications related to cesarean delivery, such as postpartum bleeding, morbidly adherent placenta and surgical site infection. Even though a systematic review and meta-analysis were done before July 2020 with limited studies, there were varies inconsistent studies after that and no updated summarize evidence about the issue as a nation. Therefore, this systematic review and meta-analysis aimed to assess the current pooled prevalence of failed induction and its associated factors in Ethiopia by including multiple inconsistent studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Comprehensive literature was searched in PubMed, Google Scholar, and HINARI from January 1, 2013, to September 23, 2023. A random effect model was used to estimate pooled prevalence and adjusted odds ratio. Stata (version17.0) was used to analyze the data. Cochrane Q-test and I squared statistics were computed to assess heterogeneity among studies. A sub group analysis was done based on study region to minimize underling heterogeneity. Funnel plot and Eggers test were done to assess publication bias and corrected by trim and fill analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Result<\/jats:title>\n                    <jats:p>Overall, one thousand fifty-two articles were retrieved and finally twenty-eight studies were included in this systematic review, including 9757 participants. The pooled prevalence of failed induction of labor was 22.39% (95% CI: 21.57\u201323.21). Subgroup analysis showed that failed induction of labor was highest in Addis Ababa and lowest in Tigray region. Rural residence (AOR = 3.31, 95% CI: 2.39\u20134.57), nullipara women (AOR = 2.63, 95% CI: 2.14\u20133.24), unfavorable bishop score (AOR = 3.98, 95% CI: 2.19\u20137.08), hypertensive disorder during pregnancy (AOR = 3.63, 95% CI: 2.69\u20135.01) and premature rupture of membranes before the onset of labor (AOR = 2.51, 95% CI: 1.5\u20134.26) were significantly associated with failed induction of labor.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The pooled prevalence of failed induction of labor in Ethiopia was high. Unfavorable bishop score, nulliparous, rural residence, women who had premature rupture of membrane and hypertensive disorder during pregnancy were significantly associated with failed induction of labor. Therefore, Healthcare providers or obstetricians should consider proper cervical assessment for bishop score before the initiation of induction. The Ministry of Health ought to create a distinct set of guidelines specifically addressing the cervical ripening and\/or induction protocol for women who experienced premature rupture of membranes (PROM) and had a hypertensive disorder during pregnancy, especially those who were administered magnesium sulfate (MgSO4).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0305384","type":"journal-article","created":{"date-parts":[[2024,11,15]],"date-time":"2024-11-15T13:33:39Z","timestamp":1731677619000},"page":"e0305384","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":4,"title":["Prevalence of failed induction of labor and associated factors among women who underwent induction of labor in Ethiopia: A systematic review and meta-analysis"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4244-9100","authenticated-orcid":true,"given":"Mulat","family":"Ayele","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Befkad Derese","family":"Tilahun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gizachew","family":"Yilak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abebaw","family":"Alamrew","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amare","family":"Zewdie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eyob Shitie","family":"Lake","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,11,15]]},"reference":[{"key":"pone.0305384.ref001","first-page":"188","article-title":"Management protocol on selected obstetrics topics for hospitals","volume":"41","author":"E. 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Desta","year":"2021","journal-title":"Int. J. Gen. Med."},{"key":"pone.0305384.ref034","doi-asserted-by":"crossref","first-page":"20503121221081010","DOI":"10.1177\/20503121221081009","article-title":"Failed induction of labor and associated factors in Adama hospital medical College, Oromia regional state, Ethiopia","volume":"10","author":"E. A. Demssie","year":"2022","journal-title":"SAGE Open Med."},{"issue":"4","key":"pone.0305384.ref035","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1891\/IJC-2021-0067","article-title":"Failed Induction of Labor and Associated Factors Among Women Who Undergone Induction of Labor in Jimma Medical Center, Ethiopia: A Hospital-Based Cross-Sectional Study","volume":"12","author":"K. A. Kitaba","year":"2022","journal-title":"Int. J. Childbirth"},{"issue":"2","key":"pone.0305384.ref036","doi-asserted-by":"crossref","first-page":"132","DOI":"10.3109\/14767058.2012.722729","article-title":"Labor induction with prostaglandin E2: characteristics of response and prediction of failure","volume":"26","author":"N. Melamed","year":"2013","journal-title":"J. Matern. Neonatal Med."},{"issue":"1","key":"pone.0305384.ref037","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12884-021-03862-x","article-title":"Predicting factors of failed induction of labor in three hospitals of Southwest Ethiopia: a cross-sectional study","volume":"21","author":"A. G. Ejigu","year":"2021","journal-title":"BMC Pregnancy Childbirth"},{"key":"pone.0305384.ref038","doi-asserted-by":"crossref","first-page":"686682","DOI":"10.3389\/fpubh.2021.686682","article-title":"Proportion and outcome of induction of labor among mothers who delivered in teaching hospital, Southwest Ethiopia","volume":"9","author":"T. 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J."},{"key":"pone.0305384.ref042","article-title":"COLLEGE OF HEALTH AND MEDICAL SCIENCES DEPARTMENT OF OBSTETRICS AND GYNECOLOGY","author":"A. Mekonnen","year":"2021","journal-title":"Haramaya university"},{"issue":"1","key":"pone.0305384.ref043","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12884-020-02862-7","article-title":"Prevalence, outcomes and associated factors of labor induction among women delivered at public hospitals of MEKELLE town-(a hospital based cross sectional study)","volume":"20","author":"G. D. Lueth","year":"2020","journal-title":"BMC Pregnancy Childbirth"},{"issue":"9","key":"pone.0305384.ref044","doi-asserted-by":"crossref","first-page":"1655","DOI":"10.1080\/03007995.2022.2103959","article-title":"Failed induction of labor and associated factors among women delivered in Jigjiga University Sheik Hassan Yabare Referral Hospital: a cross-sectional study","volume":"38","author":"A. Mebratu","year":"2022","journal-title":"Curr. Med. Res. 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Women\u2019s Heal."},{"issue":"11","key":"pone.0305384.ref055","first-page":"717","article-title":"Failed Induction of Labor\u202f: Strategies to","volume":"66","author":"C. M. E. Reviewarticle","year":"2011"},{"key":"pone.0305384.ref056","first-page":"1","article-title":"Failed induction of labor","author":"C. Schoen","year":"2015","journal-title":"Semin. Perinatol."},{"key":"pone.0305384.ref057","first-page":"2","article-title":"SMFM Papers The impact of duration of labor induction on cesarean rate","author":"K. A. 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