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Labor progression and risk of cesarean delivery in electively induced nulliparas
Journal article   Peer reviewed

Labor progression and risk of cesarean delivery in electively induced nulliparas

Anjel Vahratian, Jun Zhang, James F Troendle, Anthony C Sciscione and Matthew K Hoffman
Obstetrics and gynecology (New York. 1953), v 105(4), pp 698-704
Apr 2005
PMID: 15802393

Abstract

Adult Cervix Uteri - pathology Cesarean Section - statistics & numerical data Delaware - epidemiology Dystocia - epidemiology Dystocia - etiology Dystocia - surgery Elective Surgical Procedures - adverse effects Elective Surgical Procedures - statistics & numerical data Female Humans Labor, Induced - adverse effects Labor, Induced - statistics & numerical data Medical Records Parity Retrospective Studies Risk Factors Time Factors Pregnancy
To describe the pattern of labor progression and risk of cesarean delivery in women whose labor was electively induced. We analyzed data on all low-risk, nulliparous women with an elective induction or spontaneous onset of labor between 37 + 0 and 40 + 6 weeks from January 2002 to March 2004 at a single institution. The median duration of labor by each centimeter of cervical dilation and the risk of cesarean delivery were computed for 143 women with preinduction cervical ripening and oxytocin induction, 286 women with oxytocin induction, and 1,771 women with a spontaneous onset of labor. An intracervical Foley catheter was used to ripen the cervix. Electively induced labor with cervical ripening had substantially slower latent and early active phases. After controlling for potential confounders, women who had an elective induction with cervical ripening had 3.5 times the risk of cesarean delivery during the first stage of labor (95% confidence interval 2.7-4.5), compared with those admitted in spontaneous labor. Elective induction without cervical ripening, on the other hand, was associated with a faster labor progression from 4 to 10 cm (266 compared with 358 minutes, P < .01) and did not increase the risk of cesarean delivery, compared with those in spontaneous labor. The pattern of labor progression differs substantially for women with an electively induced labor compared with those with spontaneous onset of labor. Furthermore, elective induction in nulliparous women with an unfavorable cervix has a high rate of labor arrest and a substantially increased risk of cesarean delivery. II-2.

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Collaboration types
Domestic collaboration
Web of Science research areas
Obstetrics & Gynecology
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