Elective Induction Compared With Expectant Management in Nulliparous Women With a Favorable Cervix
- 1 September 2010
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Obstetrics & Gynecology
- Vol. 116 (3), 601-605
- https://doi.org/10.1097/aog.0b013e3181eb6e9b
Abstract
To compare outcomes of labor between nulliparous women with a favorable cervix who underwent either elective labor induction or expectant management beyond 39 weeks of gestation. A retrospective cohort study was conducted of nulliparous women with a singleton gestation who had a favorable cervix (modified Bishop score of at least 5) and delivered between 2006 and 2008. Two hundred ninety-four nulliparous women who underwent elective induction of labor between 39 and 40 5/7 weeks of gestation were compared with 294 nulliparous women who were expectantly managed beyond 39 weeks of gestation. The primary outcome, cesarean delivery, was similar between the two groups (20.8% compared with 20.1%, respectively, P=.84), a result that did not change in multivariable analysis. There were also no significant differences in other maternal (eg, chorioamnionitis, meconium, operative vaginal delivery, third- and fourth-degree lacerations, postpartum hemorrhage), or neonatal (arterial cord pH less than 7.0, Apgar score less than 4 at 5 minutes, neonatal intensive care unit admission) outcomes. Women who underwent an elective labor induction did have longer duration in labor and delivery between admission and delivery (median 12.7 compared with 9.0 hours, P<.001). For nulliparous women with a favorable cervix, elective labor induction has a similar chance of resulting in cesarean delivery as expectant management, although it appears to result in an increase in resource use. II.Keywords
This publication has 16 references indexed in Scilit:
- ACOG Practice Bulletin No. 107: Induction of LaborObstetrics & Gynecology, 2009
- Induction of labor and cesarean delivery by gestational ageAmerican Journal of Obstetrics and Gynecology, 2006
- Bishop Score and Risk of Cesarean Delivery After Induction of Labor in Nulliparous WomenObstetrics & Gynecology, 2005
- Labor Progression and Risk of Cesarean Delivery in Electively Induced NulliparasObstetrics & Gynecology, 2005
- ACOG Practice Bulletin #55: Management of Postterm PregnancyObstetrics & Gynecology, 2004
- Intervention Rates after Elective Induction of Labor Compared to Labor with a Spontaneous OnsetGynecologic and Obstetric Investigation, 2003
- Maternal and neonatal outcomes after induction of labor without an identified indicationAmerican Journal of Obstetrics and Gynecology, 2000
- Risk of cesarean delivery with elective induction of labor at term in nulliparous womenPublished by Ovid Technologies (Wolters Kluwer Health) ,1999
- Is Induction of Labor Indicated in Prolonged Pregnancy?Gynecologic and Obstetric Investigation, 1989
- ELECTIVE INDUCTION OF LABOUR: A Randomised Prospective TrialThe Lancet, 1975