Skip to main content
Top
Published in: Archives of Gynecology and Obstetrics 3/2013

01-03-2013 | Maternal-Fetal Medicine

Delivery outcomes in women undergoing elective labor induction at term

Authors: Teresa Tam, Mary Conte, Hayley Schuler, Socorro Malang, Marya Roque

Published in: Archives of Gynecology and Obstetrics | Issue 3/2013

Login to get access

Abstract

Objective

To determine elective induction of labor outcomes in term, low-risk women who delivered in a community teaching hospital.

Methods

This is a retrospective cohort study of women admitted from January 1, 2006 to January 31, 2010, for elective induction of labor. A comprehensive search of the perinatal database identified low-risk patients at ≥39 weeks gestation and ≤41 weeks with singleton pregnancies in vertex presentation. Data abstracted from manual chart review included patient demographics, admission cervical examination, and induction method. Outcome measures were delivery method and cesarean indications. Time categories calculated were mean times from induction to delivery, delivery to discharge, and total hospital length-of-stay. Descriptive statistics, frequencies, and percentages were reported using multiple regression analysis, analysis of variance, and effect tests with respective values reported. Data were analyzed using JMP software by SAS Institute Inc.

Results

Of the 1,159 women identified, 848 records passed exclusion criteria. Vaginal delivery was accomplished for 694 (81.8 %) of patients. The most common induction agent was oxytocin (73.7 %). Induction of labor with oxytocin and artificial rupture of membranes revealed a statistically significant shorter length of induction with average induction of labor for oxytocin of 11.9 h. Multiparous patients of parity >1 and patients presenting with cervical dilation of 3–4 cm had a statistically significant higher probability of vaginal delivery. Patients induced with a foley bulb or dinoprostone had statistically longer induction times (28.2 and 24.9 h, respectively) and had a statistically significant higher probability of cesarean delivery.

Conclusion

Multiparous patients and patients with a favorable cervix (>2 cm) were more likely to have a vaginal delivery and shorter length of induction.
Literature
1.
go back to reference Crane JM (2006) Factors predicting labor induction success: a critical analysis. Clin Obstet Gynecol 49:573–581PubMedCrossRef Crane JM (2006) Factors predicting labor induction success: a critical analysis. Clin Obstet Gynecol 49:573–581PubMedCrossRef
2.
go back to reference Beebe LA, Rayburn WF, Beaty CM, Eberly KL, Stanley JR, Rayburn LA (2000) Indications for labor induction. Differences between university and community hospitals. J Reprod Med 45(6):469–475PubMed Beebe LA, Rayburn WF, Beaty CM, Eberly KL, Stanley JR, Rayburn LA (2000) Indications for labor induction. Differences between university and community hospitals. J Reprod Med 45(6):469–475PubMed
3.
go back to reference Rayburn W, Zhang J (2002) Rising rates of labor induction: present concerns and future strategies. Obstet Gynecol 100:164–167PubMedCrossRef Rayburn W, Zhang J (2002) Rising rates of labor induction: present concerns and future strategies. Obstet Gynecol 100:164–167PubMedCrossRef
4.
go back to reference Clark SL, Miller DD, Belfort MA et al (2009) Neonatal and maternal outcomes associated with elective term delivery. Am J Obstet Gynecol 200:156–158PubMed Clark SL, Miller DD, Belfort MA et al (2009) Neonatal and maternal outcomes associated with elective term delivery. Am J Obstet Gynecol 200:156–158PubMed
5.
go back to reference Vrouenraets FP, Roumen FJ, Dehing CJ et al (2005) Bishop Score and risk of cesarean delivery after induction of labor in nulliparous women. Obstet Gynecol 105:690PubMedCrossRef Vrouenraets FP, Roumen FJ, Dehing CJ et al (2005) Bishop Score and risk of cesarean delivery after induction of labor in nulliparous women. Obstet Gynecol 105:690PubMedCrossRef
6.
go back to reference Luthy DA, Malmgren JA, Zingheim RW (2004) Cesarean delivery after elective induction in nulliparous women: the physician effect. Am J Obstet Gynecol 191:1511PubMedCrossRef Luthy DA, Malmgren JA, Zingheim RW (2004) Cesarean delivery after elective induction in nulliparous women: the physician effect. Am J Obstet Gynecol 191:1511PubMedCrossRef
8.
go back to reference Vahratian A, Zhang J, Troendle JF et al (2005) Labor progression and risk of cesarean delivery in electively induced nulliparas. Obstet Gynecol 105:698–704PubMedCrossRef Vahratian A, Zhang J, Troendle JF et al (2005) Labor progression and risk of cesarean delivery in electively induced nulliparas. Obstet Gynecol 105:698–704PubMedCrossRef
9.
go back to reference American College of Obstetricians and Gynecologists (2009) ACOG Practice Bulletin No. 107: induction of labor. Obstet Gynecol 114:386–397CrossRef American College of Obstetricians and Gynecologists (2009) ACOG Practice Bulletin No. 107: induction of labor. Obstet Gynecol 114:386–397CrossRef
10.
go back to reference Seyb ST, Berka RJ, Socol ML et al (1999) Risk of cesarean delivery with elective induction of labor at term in nulliparous women. Obstet Gynecol 94:600–607PubMedCrossRef Seyb ST, Berka RJ, Socol ML et al (1999) Risk of cesarean delivery with elective induction of labor at term in nulliparous women. Obstet Gynecol 94:600–607PubMedCrossRef
11.
go back to reference Zhang J, Yancy MK, Henderson CE (2002) National trends in labor induction, 1989–1998. JRM 47:120–124 Zhang J, Yancy MK, Henderson CE (2002) National trends in labor induction, 1989–1998. JRM 47:120–124
12.
go back to reference Martin JA, Hamilton BE, Sutton PD, Ventura SJ, Menacker F, Kirmeyer S et al (2009) Births: final data for 2006. Natl Vital Stat Rep 57:1–102 Martin JA, Hamilton BE, Sutton PD, Ventura SJ, Menacker F, Kirmeyer S et al (2009) Births: final data for 2006. Natl Vital Stat Rep 57:1–102
Metadata
Title
Delivery outcomes in women undergoing elective labor induction at term
Authors
Teresa Tam
Mary Conte
Hayley Schuler
Socorro Malang
Marya Roque
Publication date
01-03-2013
Publisher
Springer-Verlag
Published in
Archives of Gynecology and Obstetrics / Issue 3/2013
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-012-2582-1

Other articles of this Issue 3/2013

Archives of Gynecology and Obstetrics 3/2013 Go to the issue