DOI: https://dx.doi.org/10.18203/2320-1770.ijrcog20174997
Published: 2017-10-28

Elective induction versus spontaneous labor at term: prospective study of outcome and complications

Sagarika Babu, Lakshmi Manjeera M.

Abstract


Background: This study aims at identifying the association between inductions of labor in nullipara and multipara to caesarean delivery and other associated maternal and neonatal outcomes.

Methods: The study subjects were divided into two groups, elective induction group and spontaneous labor group. They were matched for maternal age, parity and gestational age. Duration of first and second stage of labor, mode of delivery, if caesarean section, indication for caesarean section and its relation to Bishop score, maternal age, birth weight was analyzed. Maternal intrapartum and post-partum complications and fetal outcome were also analyzed.

Results: Out of the 400 women in the study, 200 were induced and 200 were those who went into spontaneous labor. The rate of cesarean section rate among induced group is 31% and was statistically significant. But the analysis of the same after excluding risk factors like nulliparity, Bishop score <5 and birth weight >3.5 kg it was found that the rate of cesarean section is 37.1%, but was statistically not significant when compared to the spontaneous group.There was significant decrease in the duration of second stage of labor in the induced primipara group with p value of 0.038. There was no significant difference in the maternal and neonatal complications.

Conclusions: This study concludes that elective induction in carefully selected low risk population, excluding the above-mentioned risk factors does not pose any increased risk of cesarean section. Elective induction does not cause any increased risk to mother and fetus.


Keywords


Foetal outcome caesarean delivery, Induction of labour, Maternal outcome

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References


Eke AC, Okigbo C. Mechanical methods for induction of labor: RHL Commentary (Last revised: 1 Aug 2012). The WHO Reproductive Health Library; Geneva: World Health Organization.

Cunningham, Leveno, Bloom, Spong, Dash, Hoffman, Casey, Sheffield (editors). Induction and augmentation of labor. Williams Obstetrics. 24th ed. Mc Graw-Hill;2014:523-534.

Zhang J, Yancey MK, Henderson CE. U.S. National trends in labor induction;1989-1998. J Reprod Med. 2002;47(2):120-4.

Konar H (editor). Induction of labor. DC Dutta’s Textbook of Obstetrics. 8th ed. 2013:598-608.

Macer JA, Macer CL. Elective induction versus spontaneous labor: A retrospective study of complications and outcome. Am J Obstet Gynecol. 1992;166:1690-7.

Maslow AS, Sweeney AL. Elective induction of labor as a risk factor for cesarean delivery among low risk woman at term. Obstet Gynecol. 2000;95:917-922.

Prysak M, Castronova FC. Elective induction versus spontaneous labor a case control analysis of safety and efficacy. Obstet Gynecol. 1998;92:47-52

Sande HA, Tuveng J, Fonstelier T. A prospective randomized study of induction of labor. Int J Gynaecol Obstet. 1983;21: 333-6.

Seyb ST, Berka RJ, Socol ML, Dooley SL. Risk of Cesarean Delivery with Elective Induction of labor at term in nulliparous women. Obstet Gynecol. 1999;94:600-7.

Vahratian A, Zhang J, Troendle JF. Labor progression and risk of cesarean delivery in electively induced nulipara. Obstet Gynecol 2005;105:698-704.

Cole RA, Howie PN, Macnaughton MC. Elective induction of labor: A randomized prospective trial. Lancet. 1975;1:767-70.

Smith LP, Nagourney BA. Hazards and benefits of elective induction of labor. Am J Obstet Gynecol. 1984;148:579-585.

Kato K, Nagata I, Furuya K, Makimura N. Programmed induction of labor for primiparous women to ensure day time delivery. Asia Oceania J Obstet Gynecol. 1987;13:405-15.