Medical Journal of Obstetrics and Gynecology

Rate of Failed Induction of Labor at a Single Academic Medical Center in Saudi Arabia: A 10 Year Experience

Research Article | Open Access | Volume 11 | Issue 3

  • 1. Faculty of Medicine, King Abdulaziz University, Saudi Arabia
  • 2. Department of Obstetrics and Gynecology, King Abdulaziz University Hospital, Saudi Arabia
+ Show More - Show Less
Corresponding Authors
Samera AlBasri, Department of Obstetrics and Gynecology, King Abdulaziz University Hospital, Faculty of Medicine, Jeddah, Saudi Arabia, Tel: 966505653412

Failed induction of labor (IOL) often necessitates cesarean section (CS), which is associated with serious obstetric complications. However, there are no updated studies about the factors associated with and complications of failed IOL in Saudi Arabia. Therefore, this retrospective study reviews the hospital records of 127 cases of failed IOL followed by emergency CS from King Abdulaziz University Hospital, Jeddah, Saudi Arabia, over a 10-year period (May 2012 to June 2022). The study included 127 pregnant women, who comprised 1.13% of 11238 CS cases and 4.9% of 2582 IOL cases. Preeclampsia (44, 34.65%) and post-date pregnancy (24, 18.90%) were the most common indications for IOL. Nulliparous women were the dominant group (88, 69.29%), and prostaglandin E1 was the most commonly used induction agent (98, 77.17%).

Postpartum hemorrhage was the most common maternal complication (5, 3.94%), and neonatal intensive care unit admission (17, 24.41%) and low pH (26, 20.47%) were the most common fetal outcomes. The findings indicate that IOL is safe as long as it is performed based on the standards of care and available evidence.


• Induction of labor

• Failed induction of labor

• Maternal complications


Alzharani FA, AlBasri SF, Khashab RA, Alamoudi MM, Badawi DM, et al. (2023) Rate of Failed Induction of Labor at a Single Academic Medi cal Center in Saudi Arabia: A 10-Year Experience. Med J Obstet Gynecol 11(3): 1177.


Induction of labor (IOL) is a frequently used technique in modern obstetrics that involves the iatrogenic stimulation of uterine contractions before spontaneous commencement of labor to promote vaginal birth [1]. According to the World Health Organization, IOL is indicated mainly for enhancement of the standard of care and outcomes of the pregnancy [2], with the goal of labor induction primarily being to ensure the best outcome for the mother [3], and prevent unwanted cesarean section (CS) and potentially severe obstetric complications [2]. Some of the obstetric indications for terminating pregnancy include eclampsia, post-term pregnancy, premature rupture of membrane (PROM), gestational diabetes mellitus (GDM) at term, intrauterine growth retardation (IUGR), and placental abruption [3].Thus, IOL methods should only be used when the advantages of terminating the pregnancy outweigh the hazards of delaying labor [4], and they should only be carried out under the supervision of a physician [2].

Failed IOL is commonly defined as the inability to achieve vaginal birth with IOL methods [5], or performance of CS in the latent phase of labor induction [6]. However, some studies have suggested an alternate definition and have described failed IOL as unsuccessful induction of labor despite the induction of a strong contraction, thus necessitating CS [7,8].The majority of cases of failed IOL require CS [9], and accordingly, failed IOL has been associated with increased maternal morbidity and mortality due to the complications associated with CS, such as postpartum hemorrhage (PPH) and sepsis [8]. A previous study showed that the prevalence of failed IOL was 31.4% in Amhara regional state, Ethiopia [10], and another study carried out in Ethiopia reported the prevalence as 29.6%. In addition, PROM was found to be the most common indication for IOL (46.4%), and it was followed by hypertensive disorder of pregnancy (21.6%) [11]. With regard to the factors associated with the success of IOL, a study from Eastern Ethiopia reported that the likelihood of successfully inducing labor was 67% lower in nulliparous women than in multiparous women [12]. In addition, birth weight above 4000 g has also been found to be associated with failed IOL [11-13]. According to existing research, pregnant women who undergo IOL have a higher chance of requiring CS or instrumental delivery, PPH, and longer maternal hospitalization than those who experience spontaneous labor [14]. Considering that failed IOL has an impact on maternal health and can lead to certain maternal complications, it has become an important medical concern.

The outcomes of failed IOL are well covered in international studies, but there is limited evidence from local studies in Saudi Arabia. Therefore, the present retrospective study was conducted to determine the most relevant factors associated with failed IOL and maternal and neonatal outcomes. The study covered a 10 year period from May 2012 to June 2022 and was conducted at King Abdulaziz University Hospital (KAUH), Jeddah.


This retrospective study was approved by the Research Ethics Committee of KAUH (Reference no. 249-22). It was performed at the Obstetrics and Gynecology Department, KAUH, Jeddah, Saudi Arabia, for a 10-year period between May 2012 and June 2022. It included a sample of 127 pregnant women with gestational age above 24 weeks who underwent CS after failed IOL. Women who did not receive any augmentation, had a history of CS, had IUFD, underwent CS due to fetal distress, or had gone through the active phase of labor were excluded from this study. Data for each patient were extracted from the birth registry records and via Google forms that included the following information: maternal age, parity, induction type, induction dose, and indications for induction (such as GDM, frank DM, preeclampsia, post-date pregnancy, PROM, oligohydramnios, antepartum hemorrhage, IUGR, and fetal malformation). In addition to the timing of CS, that is, whether it is conducted during the latent or active phase, data on maternal outcomes were also collected, for example, endometritis, wound complications (infection and separation), hysterectomy, intensive care unit (ICU) admission, blood transfusion, pulmonary embolism, and maternal death. Data were also collected on neonatal characteristics such as birth weight; presence of twins, sex; whether the Apgar score at 1 and 5 min was greater, less than, or equal to 7; neonatal pH; whether the newborn was admitted to the neonatal ICU (NICU) or not; and whether neonatal death occurred. The data collected were entered into an Excel data spreadsheet (version 16.64). Statistical analysis was conducted using SPSS for Windows, version 26.


The primary focus of this retrospective study was to assess the contributing elements and outcomes of failed IOL at KAUH, Jeddah, over a 10-year period ranging from May 2012 to June 2022. The medical records of 127 women who underwent CS after failed IOL were retrieved: these 127 cases represent 1.13% of all 11238 CS cases and 4.9% of all 2582 IOL cases over the study period (Table 1). The rate of labor induction, that is, the number of deliveries for which IOL was required, was 6.8% (2582 out of 37959 deliveries). The vast majority of our sample comprised Saudi nationals (77, 60.63%). The study was carried out on all women in whom IOL had failed, regardless of their age group. However, the majority of these women were between 26 and 30 years of age (45, 35.43%), while 29 (22.83%) each were in the age groups 20–25 years and 31–35 years (Table 2). With regard to parity, 69.29% of the sample, that is, more than half of the sample, was nulliparous.

Preeclampsia was the most common factor related to failed IOL (44, 34.65%), and it was followed by post-date pregnancy (24, 18.90%), GDM (19, 14.96%), and PROM (18, 14.17%) (Table 3). Prostaglandin E1 was the most commonly used agent for induction (98, 77.17%), and prostaglandin E2 was the second most commonly used one (24, 18.90%). The least used method of IOL was cervical ripening, which was used on only 1 (0.79%) woman (Table 4). The majority of the mothers (18, 14.2%) received more than 10 doses of the induction agent (Table 5). PPH was the most common maternal complication (5, 3.94%), and it was followed by wound complications (2, 1.57%). Other complications, such as hysterectomy, ICU admission, blood transfusion, and maternal death, were not found in our sample.

In this study, most of the neonates were female (67, 52.76%), and birth weight was between 2.5 and 4 kg in 81 (63.78%) neonates and below 2.5 kg in 31 (24.41%) (Table 6). With regard to Apgar score, the number of neonates with a score below 7 at 1min was 25 (19.69%), and this number decreased significantly at 5 min to 1 (0.79%) (Figure 1).

Neonatal Apgar scores

Figure 1: Neonatal Apgar scores

pH readings revealed that 26 (20.47%) neonates had low pH, while only 1 (0.79%) had high pH. In addition, a considerable percentage of neonates required NICU admission (17, 24.41%), and one neonatal death was reported throughout the study period.


The present study investigates the most common factors and outcomes of failed IOL in a cohort from Saudi Arabia. We retrospectively reviewed the records of 127 women treated at KAUH, Jeddah, between May 2012 and June 2022, in whom IOL had failed in order to predict the relevant variables and outcomes. The age group 26 to 30 years was the most common maternal age group in our study, and it was followed by the groups 20–25 and 31–35 years, both of which had an equally high prevalence. Another study conducted in southeast Ethiopia also reported that IOL is 8.788 times more likely to fail in mothers aged 31–35 years than in mothers aged 20 years [15]. A possible contributing factor might be maternal anatomical stability in women younger than 25 years and the increase in deformities in the sacral promontory, ischial spine, and coccyx bone with age [12]. Another explanation might be the decrease in myometrial contractility with age, as this can result in poor uterine contraction and, subsequently, failed IOL [16,17].The labor induction rate (6.8%) in this cohort was the same as that reported in a study from Algeria [18], but it was lower than that reported in one study from Ethiopia (9%) [19], and higher than that reported in another study from Ethiopia (4%) [20].The prevalence of failed IOL in our study was 4.9%, which is much lower than that reported in another study (7.2%) [19].

With regard to the factors associated with failed IOL, our data indicate that the likelihood of IOL failure was higher in nulliparous women than in multiparous women. This is in agreement with the findings of studies conducted in Ethiopia [11,12,21], Saudi Arabia [22], and Ireland [23]. IOL failure in nulliparous women may be a result of direct induction before cervical ripening, amniotomy, and the undoing of cervical sweeping after the active phase of the first stage of labor [12]. Another associated factor may be the pre induction cervical status, which is different between nulliparous and multiparous women and may affect their response to induction procedures [24]. This may also be partially explained by the flexibility of the uterine muscles of multiparous women as compared to those of nulliparous women [12], in whom the cervix is immature and stimulation by induction requires more time and effort [24]. Another factor associated with failed IOL was preeclampsia, which has also been reported as an influencing factor in studies conducted in Ethiopia [11,12,24], Tanzania [25], the USA [26], and Australia [27]. Preeclampsia may increase the risk of uteroplacental insufficiency or placental abruption, which may lead to non-reassuring fetal heart rate (NRFHR) and, thereby, increase the likelihood of CS [26]. In addition, when the placenta’s function is impaired, the hormones secreted by it do not respond to uterotonic medications [11]. This may also increase the likelihood of failed IOL. Another explanation may be the administration of magnesium sulfate during labor induction for seizure prevention in patients with pregnancy-induced hypertension, as it is a known tocolytic drug [28,29], that can terminate labor and lead to slower labor progress and even failed IOL [30]. Additionally, it has been demonstrated in certain studies that magnesium sulfate reduces fetal heart rate variability, and this may explain why its administration is associated with NRFHR and the need for CS [31,32]. In the present study, post-date pregnancy was also associated with a high rate of IOL failure. This is in line with a study in Ethiopia which reported that the risk of IOL failure was 4.1 times higher in mothers who underwent IOL because of post-date pregnancy.

The association can be explained by placental calcification associated with post-date pregnancy. As the pregnancy progresses, the placenta may become calcified and its function may be comprised. As a result, the fetus’s ability to cope with uterotonic agents is affected because the flow of oxygen and other nutrients to the fetus is reduced [10]. In addition to the factors discussed so far, GDM is also associated with a relatively high rate of IOL failure. Some studies have illustrated this through the changes that occur with gestational diabetes, such as increase in fetal weight, decrease in the volume of amniotic fluid, and placental aging, all of which are associated with an increased need for intrapartum CS due to dystocia [33,34]. Finally, PROM was also associated with failure of IOL. This association may be explained by the gush of amniotic fluid, which increases the risk of ascending infection, leads to chorioamnionitis, and eventually causes NRFHR. These events may increase the chance of failed IOL by inducing fetal distress [11]. This finding is in alignment with studies from Ethiopia [11,24],and Pakistan [35].

One of the main limitations of our study is the poor documentation of hospital records, which affected the reliability of the data. Another limitation was that our study was conducted at a single center (KAUH). This also meant that the sample size was rather small. Furthermore, we did not examine some relevant variables, such as maternal cervical status, Bishop score, and clinician practice during IOL, which may have contributed to the failure of IOL. In addition, regarding our study design, there may be a lack of association between the factors and the fate of delivery, which may affect the outcomes of IOL. Finally, there is no published research in the same region of the world for comparison of our results.


Based on the evidence gathered over the 10-year period of this study, IOL appears to be a safe obstetric procedure. That is, as long as it is performed according to the standards of care and based on the best available evidence, it can protect mothers and neonates from serious outcomes.


Concept of the study: Fatmah Alzahrani

Literature review: Fatmah Alzahrani, Raghad Khashab, Maryam M Alamoudi, Deyala Badawi, Daniyah Alsharif.

Writing of the research proposal: Fatmah Alzahrani

Writing of introduction: Fatmah Alzahrani, Raghad Khashab, Maryam M Alamoudi, Deyala Badawi, Daniyah Alsharif.

Writing of Method: Fatmah Alzahrani, Raghad Khashab, Maryam M Alamoudi, Deyala Badawi, Daniyah Alsharif.

Data collection: Fatmah Alzahrani, Raghad Khashab, Maryam M Alamoudi, Deyala Badawi, Daniyah Alsharif, Atheer Almrzouqi.

Data analysis: Samera AlBasri, Fatmah Alzahrani, Raghad Khashab, Maryam M Alamoudi, Deyala Badawi, Daniyah Alsharif, Atheer Almrzouqi.

Writing of Result: Fatmah Alzahrani, Raghad Khashab, Maryam M Alamoudi, Deyala Badawi, Daniyah Alsharif.

Writing of Discussion: Fatmah Alzahrani, Raghad Khashab, Maryam M Alamoudi, Deyala Badawi, Daniyah Alsharif.

Writing of Conclusion: Fatmah Alzahrani, Raghad Khashab, Maryam M Alamoudi, Deyala Badawi, Daniyah Alsharif.

Review and edit the manuscript: Samera AlBasri, Fatmah Alzahrani, Atheer Almrzouqi. Disclosures


This study was approved by the institutional review board of the hospital, and informed consent was obtained from all included patients.


We acknowledge the assistance of Dr. Hisham Naseef for providing some articles related to the research subject.

Additional Information

This research was presented as a poster at the 1st international MFM conference at Riyadh and the 14th scientific forum at King Abdulaziz University students.


1. Talaulikar VS, Arulkumaran S. Failed induction of labor: strategies to improve the success rates. Obstet Gynecol Surv. 2011; 66: 717-728.

2. Organization WH. WHO recommendations for induction of labour: World Health Organization; 2011.

3. Bonsack CF, Lathrop A, Blackburn M. Induction of labor: update and review. Journal of Midwifery & Women’s Health. 2014; 59: 606-615.

4. Chauhan SP, Ananth CV. Induction of Labor in the United States: A Critical Appraisal of Appropriateness and Reducibility. Semin Perinatol. 2012; 36: 336-343.

5. Dilnessa T, Temesgen K, Workie A. The proportion of failed induction of labour and associated factors among women undergoing induction of labour in Dessie referral hospital: northeast Ethiopia a cross sectional study. Asian J Pregnan Childbirth. 2019: 1-13.

6. Grobman WA, Bailit J, Lai Y, Reddy UM, Wapner RJ, Varner MW, et al. Defining failed induction of labor. Am J Obstet Gynecol. 2018; 218: 122.

7. West HM, Jozwiak M, Dodd JM. Methods of term labour induction for women with a previous caesarean section. Cochrane Database of Systematic Reviews. 2017.

8. Yeast JD, Jones A, Poskin M. Induction of labor and the relationship to cesarean delivery: a review of 7001 consecutive inductions. Am J Obstet Gynecol. 1999; 180: 628-633.

9. Bassetty KC, Ahmed RD. Failed induction of labor (IOL): an overview regarding obstetric outcome and its significance in a health resource poor setting over a period of 11 months. Int J Reproduct Contraception, Obstet Gynecol. 2017; 6: 3646.

10. Debele TZ, Cherkos EA, Badi MB, Anteneh KT, Demssie FW, Abdo AA, et al. Factors and outcomes associated with the induction of labor in referral hospitals of Amhara regional state, Ethiopia: a multicenter study. BMC Pregnancy Childbirth. 2021; 21: 225.

11. Demssie EA, Deybasso HA, Tulu TM, Abebe D, Kure MA, Teji Roba K.Failed induction of labor and associated factors in Adama Hospital Medical College, Oromia Regional State, Ethiopia. SAGE Open Med. 2022; 10: 20503121221081009.

12. Beshir YM, Kure MA, Egata G, Roba KT. Outcome of induction and associated factors among induced labours in public Hospitals of Harari Regional State, Eastern Ethiopia: A two years’ retrospective analysis. PLoS One. 2021; 16: e0259723.

13. Ejigu AG, Lambyo SH. Predicting factors of failed induction of labor in three hospitals of Southwest Ethiopia: a cross-sectional study. BMC Pregnancy Childbirth. 2021; 21: 387.

14. Baud D, Rouiller S, Hohlfeld P, Tolsa JF, Vial Y. Adverse obstetrical and neonatal outcomes in elective and medically indicated inductions of labor at term. J Matern Fetal Neonatal Med. 2013; 26: 1595-1601.

15. Desta M, Duguma A. The Magnitude of Failed Induction of Labor and Associated Factors Among Women Delivered at Public Hospitals of Arsi Zone, Southeast Ethiopia, 2020: A Cross-Sectional Study. Int J Gen Med. 2021; 14: 6021-6033.

16. Arrowsmith S, Robinson H, Noble K, Wray S. What do we know about what happens to myometrial function as women age? J Muscle Res Cell Motil. 2012; 33: 209-217.

17. Al A, Al ZFMA. Outcomes of Labor in Women Undergoing Induction of Labor and Plan of Nursing Action. Port Said Scientific J Nursing. 2017; 4: 28-49.

18. Vogel JP, Souza JP, Gülmezoglu AM. Patterns and outcomes of induction of labour in Africa and Asia: a secondary analysis of the WHO Global Survey on Maternal and Neonatal Health. PloS one. 2013; 8: e65612.

19. Lueth GD, Kebede A, Medhanyie AA. Prevalence, outcomes and associated factors of labor induction among women delivered at public hospitals of MEKELLE town-(a hospital based cross sectional study). BMC Pregnancy Childbirth. 2020; 20: 203.

20. Berhan Y, Dwivedi A. Currently used oxytocin regimen outcome measures at term & postterm. I: Outcome indicators in relation to parity & indication for induction. Ethiop Med J. 2007; 45: 235-242.

21. Yosef T, Getachew D. Proportion and Outcome of Induction of Labor among Mothers Who Delivered in Teaching Hospital, Southwest Ethiopia. Front Public Health. 2021; 9: 686682.

22. Al-Shaikh GK, Wahabi HA, Fayed AA, Esmaeil SA, Al-Malki GA. Factors associated with successful induction of labor. Saudi Med J. 2012; 33: 298-303.

23. O’Dwyer V, O’Kelly S, Monaghan B, Rowan A, Farah N, Turner MJ. Maternal obesity and induction of labor. Acta Obstet Gynecol Scand. 2013; 92: 1414-1418.

24. Tadesse T, Assefa N, Roba HS, Baye Y. Failed induction of labor and associated factors among women undergoing induction at University of Gondar Specialized Hospital, Northwest Ethiopia. BMC Pregnancy Childbirth. 2022; 22: 175.

25. Tarimo CS, Mahande MJ, Obure J. Prevalence and risk factors for caesarean delivery following labor induction at a tertiary hospital in North Tanzania: a retrospective cohort study (2000-2015). BMC Pregnancy Childbirth. 2020; 20: 173.

26. Kim LH, Cheng YW, Delaney S, Jelin AC, Caughey AB. Is preeclampsia associated with an increased risk of cesarean delivery if labor is induced? J Matern Fetal Neonatal Med. 2010; 23: 383-388.

27. Thornton CE, Dahlen HG, Hennessy A. Does induction of labour in nulliparous hypertensive women result in vaginal birth? - A descriptive study utilising birth registry data. Pregnancy Hypertens. 2018; 12: 16-22.

28. Güden M, Akkurt M, Eri? Yalç?n S, Co?kun B, Akkurt I, Yavuz A, et al. A comparison of the effects of the most commonly used tocolytic agents on maternal and fetal blood flow. Turk J Obstet Gynecol. 2016; 13: 85-89.

29. Kawagoe Y, Sameshima H, Ikenoue T, Yasuhi I, Kawarabayashi T. Magnesium sulfate as a second- line tocolytic agent for preterm labor: a randomized controlled trial in Kyushu Island. J Pregnancy. 2011; 2011: 965060.

30. Park KH, Cho YK, Lee CM, Choi H, Kim BR, Lee HK. Effect of preeclampsia, magnesium sulfate prophylaxis, and maternal weight on labor induction: a retrospective analysis. Gynecol Obstet Invest. 2006; 61: 40-44.

31. Hiett AK, Devoe LD, Brown HL, Watson J. Effect of magnesium on fetal heart rate variability using computer analysis. Am J Perinatol. 1995; 12: 259-261.

32. Guzman ER, Conley M, Stewart R, Ivan J, Pitter M, Kappy K. Phenytoin and magnesium sulfate effects on fetal heart rate tracings assessed by computer analysis. Obstet Gynecol. 1993; 82: 375-379.

33. Caughey AB, Sundaram V, Kaimal AJ, Gienger A, Cheng YW, McDonald KM, et al. Systematic review: elective induction of labor versus expectant management of pregnancy. Ann Int Med. 2009; 151: 252 263.

34. Hannah ME, Hannah WJ, Hellmann J, Hewson S, Milner R, Willan A, et al. Induction of labor as compared with serial antenatal monitoring in post-term pregnancy: a randomized controlled trial. N Engl J Med. 1992; 326: 1587-1592.

35. Khan NB, Ahmed I, Malik A, Sheikh L. Factors associated with failed induction of labour in a secondary care hospital. J Pak Med Assoc. 2012; 62: 6-10.

Alzharani FA, AlBasri SF, Khashab RA, Alamoudi MM, Badawi DM, et al. (2023) Rate of Failed Induction of Labor at a Single Academic Medi cal Center in Saudi Arabia: A 10-Year Experience. Med J Obstet Gynecol 11(3): 1177.

Received : 06 Sep 2023
Accepted : 27 Oct 2023
Published : 30 Oct 2023
Annals of Otolaryngology and Rhinology
ISSN : 2379-948X
Launched : 2014
JSM Schizophrenia
Launched : 2016
Journal of Nausea
Launched : 2020
JSM Internal Medicine
Launched : 2016
JSM Hepatitis
Launched : 2016
JSM Oro Facial Surgeries
ISSN : 2578-3211
Launched : 2016
Journal of Human Nutrition and Food Science
ISSN : 2333-6706
Launched : 2013
JSM Regenerative Medicine and Bioengineering
ISSN : 2379-0490
Launched : 2013
JSM Spine
ISSN : 2578-3181
Launched : 2016
Archives of Palliative Care
ISSN : 2573-1165
Launched : 2016
JSM Nutritional Disorders
ISSN : 2578-3203
Launched : 2017
Annals of Neurodegenerative Disorders
ISSN : 2476-2032
Launched : 2016
Journal of Fever
ISSN : 2641-7782
Launched : 2017
JSM Bone Marrow Research
ISSN : 2578-3351
Launched : 2016
JSM Mathematics and Statistics
ISSN : 2578-3173
Launched : 2014
Journal of Autoimmunity and Research
ISSN : 2573-1173
Launched : 2014
JSM Arthritis
ISSN : 2475-9155
Launched : 2016
JSM Head and Neck Cancer-Cases and Reviews
ISSN : 2573-1610
Launched : 2016
JSM General Surgery Cases and Images
ISSN : 2573-1564
Launched : 2016
JSM Anatomy and Physiology
ISSN : 2573-1262
Launched : 2016
JSM Dental Surgery
ISSN : 2573-1548
Launched : 2016
Annals of Emergency Surgery
ISSN : 2573-1017
Launched : 2016
Annals of Mens Health and Wellness
ISSN : 2641-7707
Launched : 2017
Journal of Preventive Medicine and Health Care
ISSN : 2576-0084
Launched : 2018
Journal of Chronic Diseases and Management
ISSN : 2573-1300
Launched : 2016
Annals of Vaccines and Immunization
ISSN : 2378-9379
Launched : 2014
JSM Heart Surgery Cases and Images
ISSN : 2578-3157
Launched : 2016
Annals of Reproductive Medicine and Treatment
ISSN : 2573-1092
Launched : 2016
JSM Brain Science
ISSN : 2573-1289
Launched : 2016
JSM Biomarkers
ISSN : 2578-3815
Launched : 2014
JSM Biology
ISSN : 2475-9392
Launched : 2016
Archives of Stem Cell and Research
ISSN : 2578-3580
Launched : 2014
Annals of Clinical and Medical Microbiology
ISSN : 2578-3629
Launched : 2014
JSM Pediatric Surgery
ISSN : 2578-3149
Launched : 2017
Journal of Memory Disorder and Rehabilitation
ISSN : 2578-319X
Launched : 2016
JSM Tropical Medicine and Research
ISSN : 2578-3165
Launched : 2016
JSM Head and Face Medicine
ISSN : 2578-3793
Launched : 2016
JSM Cardiothoracic Surgery
ISSN : 2573-1297
Launched : 2016
JSM Bone and Joint Diseases
ISSN : 2578-3351
Launched : 2017
JSM Bioavailability and Bioequivalence
ISSN : 2641-7812
Launched : 2017
JSM Atherosclerosis
ISSN : 2573-1270
Launched : 2016
Journal of Genitourinary Disorders
ISSN : 2641-7790
Launched : 2017
Journal of Fractures and Sprains
ISSN : 2578-3831
Launched : 2016
Journal of Autism and Epilepsy
ISSN : 2641-7774
Launched : 2016
Annals of Marine Biology and Research
ISSN : 2573-105X
Launched : 2014
JSM Health Education & Primary Health Care
ISSN : 2578-3777
Launched : 2016
JSM Communication Disorders
ISSN : 2578-3807
Launched : 2016
Annals of Musculoskeletal Disorders
ISSN : 2578-3599
Launched : 2016
Annals of Virology and Research
ISSN : 2573-1122
Launched : 2014
JSM Renal Medicine
ISSN : 2573-1637
Launched : 2016
Journal of Muscle Health
ISSN : 2578-3823
Launched : 2016
JSM Genetics and Genomics
ISSN : 2334-1823
Launched : 2013
JSM Anxiety and Depression
ISSN : 2475-9139
Launched : 2016
Clinical Journal of Heart Diseases
ISSN : 2641-7766
Launched : 2016
Annals of Medicinal Chemistry and Research
ISSN : 2378-9336
Launched : 2014
JSM Pain and Management
ISSN : 2578-3378
Launched : 2016
JSM Women's Health
ISSN : 2578-3696
Launched : 2016
Clinical Research in HIV or AIDS
ISSN : 2374-0094
Launched : 2013
Journal of Endocrinology, Diabetes and Obesity
ISSN : 2333-6692
Launched : 2013
Journal of Substance Abuse and Alcoholism
ISSN : 2373-9363
Launched : 2013
JSM Neurosurgery and Spine
ISSN : 2373-9479
Launched : 2013
Journal of Liver and Clinical Research
ISSN : 2379-0830
Launched : 2014
Journal of Drug Design and Research
ISSN : 2379-089X
Launched : 2014
JSM Clinical Oncology and Research
ISSN : 2373-938X
Launched : 2013
JSM Bioinformatics, Genomics and Proteomics
ISSN : 2576-1102
Launched : 2014
JSM Chemistry
ISSN : 2334-1831
Launched : 2013
Journal of Trauma and Care
ISSN : 2573-1246
Launched : 2014
JSM Surgical Oncology and Research
ISSN : 2578-3688
Launched : 2016
Annals of Food Processing and Preservation
ISSN : 2573-1033
Launched : 2016
Journal of Radiology and Radiation Therapy
ISSN : 2333-7095
Launched : 2013
JSM Physical Medicine and Rehabilitation
ISSN : 2578-3572
Launched : 2016
Annals of Clinical Pathology
ISSN : 2373-9282
Launched : 2013
Annals of Cardiovascular Diseases
ISSN : 2641-7731
Launched : 2016
Journal of Behavior
ISSN : 2576-0076
Launched : 2016
Annals of Clinical and Experimental Metabolism
ISSN : 2572-2492
Launched : 2016
Clinical Research in Infectious Diseases
ISSN : 2379-0636
Launched : 2013
JSM Microbiology
ISSN : 2333-6455
Launched : 2013
Journal of Urology and Research
ISSN : 2379-951X
Launched : 2014
Journal of Family Medicine and Community Health
ISSN : 2379-0547
Launched : 2013
Annals of Pregnancy and Care
ISSN : 2578-336X
Launched : 2017
JSM Cell and Developmental Biology
ISSN : 2379-061X
Launched : 2013
Annals of Aquaculture and Research
ISSN : 2379-0881
Launched : 2014
Clinical Research in Pulmonology
ISSN : 2333-6625
Launched : 2013
Journal of Immunology and Clinical Research
ISSN : 2333-6714
Launched : 2013
Annals of Forensic Research and Analysis
ISSN : 2378-9476
Launched : 2014
JSM Biochemistry and Molecular Biology
ISSN : 2333-7109
Launched : 2013
Annals of Breast Cancer Research
ISSN : 2641-7685
Launched : 2016
Annals of Gerontology and Geriatric Research
ISSN : 2378-9409
Launched : 2014
Journal of Sleep Medicine and Disorders
ISSN : 2379-0822
Launched : 2014
JSM Burns and Trauma
ISSN : 2475-9406
Launched : 2016
Chemical Engineering and Process Techniques
ISSN : 2333-6633
Launched : 2013
Annals of Clinical Cytology and Pathology
ISSN : 2475-9430
Launched : 2014
JSM Allergy and Asthma
ISSN : 2573-1254
Launched : 2016
Journal of Neurological Disorders and Stroke
ISSN : 2334-2307
Launched : 2013
Annals of Sports Medicine and Research
ISSN : 2379-0571
Launched : 2014
JSM Sexual Medicine
ISSN : 2578-3718
Launched : 2016
Annals of Vascular Medicine and Research
ISSN : 2378-9344
Launched : 2014
JSM Biotechnology and Biomedical Engineering
ISSN : 2333-7117
Launched : 2013
Journal of Hematology and Transfusion
ISSN : 2333-6684
Launched : 2013
JSM Environmental Science and Ecology
ISSN : 2333-7141
Launched : 2013
Journal of Cardiology and Clinical Research
ISSN : 2333-6676
Launched : 2013
JSM Nanotechnology and Nanomedicine
ISSN : 2334-1815
Launched : 2013
Journal of Ear, Nose and Throat Disorders
ISSN : 2475-9473
Launched : 2016
JSM Ophthalmology
ISSN : 2333-6447
Launched : 2013
Journal of Pharmacology and Clinical Toxicology
ISSN : 2333-7079
Launched : 2013
Annals of Psychiatry and Mental Health
ISSN : 2374-0124
Launched : 2013
Annals of Pediatrics and Child Health
ISSN : 2373-9312
Launched : 2013
JSM Clinical Pharmaceutics
ISSN : 2379-9498
Launched : 2014
JSM Foot and Ankle
ISSN : 2475-9112
Launched : 2016
JSM Alzheimer's Disease and Related Dementia
ISSN : 2378-9565
Launched : 2014
Journal of Addiction Medicine and Therapy
ISSN : 2333-665X
Launched : 2013
Journal of Veterinary Medicine and Research
ISSN : 2378-931X
Launched : 2013
Annals of Public Health and Research
ISSN : 2378-9328
Launched : 2014
Annals of Orthopedics and Rheumatology
ISSN : 2373-9290
Launched : 2013
Journal of Clinical Nephrology and Research
ISSN : 2379-0652
Launched : 2014
Annals of Community Medicine and Practice
ISSN : 2475-9465
Launched : 2014
Annals of Biometrics and Biostatistics
ISSN : 2374-0116
Launched : 2013
JSM Clinical Case Reports
ISSN : 2373-9819
Launched : 2013
Journal of Cancer Biology and Research
ISSN : 2373-9436
Launched : 2013
Journal of Surgery and Transplantation Science
ISSN : 2379-0911
Launched : 2013
Journal of Dermatology and Clinical Research
ISSN : 2373-9371
Launched : 2013
JSM Gastroenterology and Hepatology
ISSN : 2373-9487
Launched : 2013
Annals of Nursing and Practice
ISSN : 2379-9501
Launched : 2014
JSM Dentistry
ISSN : 2333-7133
Launched : 2013
Author Information X