Institutional Outcomes Associated With Elective Induction of Labor Between 39.0–40.6 Weeks [4L]

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Abstract

INTRODUCTION:

Outcomes of elective inductions of labor between 39–40.6 weeks at an academic center were assessed in terms of route of delivery, NICU admissions, and induction length. Characteristics of those who delivered vaginally versus via Cesarean section were described.

METHODS:

Outcomes of 169 women with singleton, cephalic gestations who underwent elective induction of labor over a two year period were assessed. Primary endpoints were route of delivery, NICU admissions and length of induction. Secondary variables were age, gravidity, parity, initial cervical exam, mode of induction, maternal comorbidities, delivery complications and days inpatient. Student's t test was used for statistical analysis.

RESULTS:

Of 169 patients, 155 (92%) delivered vaginally and 14 (8%) underwent Cesarean section. Statistically significant differences (P<.05) were noted in length of induction (12.1 versus 16.9 hours), age (28.18 versus 23.71 years), gestational age (39.4 versus 40.1 weeks), days hospitalized (3 versus 4.6), initial cervical dilation (3 versus 2 cm), gravidity (3 versus 2), and parity (1.4 versus 0.43) when comparing those who ultimately delivered vaginally versus via Cesarean section. Delivery complications were noted in 17% of the vaginal and 29% of the Cesarean section groups (P=.27). NICU admissions occurred in 4% of vaginal deliveries and 7% of Cesarean deliveries (P=.57).

CONCLUSION:

The number of patients undergoing Cesarean section was substantially less than expected, as this institution reports an approximately 25% rate of Cesarean section. This highlights the importance of patient selection when considering an elective induction, as those with a favorable cervix or multiparous status were more likely to deliver vaginally.

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