Abstract
Objective: To determine whether elective induction of labor in nulliparous women is associated
with changes in fetomaternal outcome when compared with labor of spontaneous onset.
Study Design: All 80 labor wards in Flanders (Northern Belgium) comprised a matched cohort study.
From 1996 through 1997, 7683 women with elective induced labor and 7683 women with
spontaneous labor were selected according to the following criteria: nulliparity,
singleton pregnancy, cephalic presentation, gestational age at the time of delivery
of 266 to 287 days, and birth weight between 3000 and 4000 g. Each woman with induced
labor and the corresponding woman with spontaneous labor came from the same labor
ward, and they had babies of the same sex. Both groups were compared with respect
to the incidence of cesarean delivery or instrument delivery and the incidence of
transfer to the neonatal ward. Results: Cesarean delivery (9.9% vs 6.5%), instrumental delivery (31.6% vs 29.1%), epidural
analgesia (80% vs 58%), and transfer of the baby to the neonatal ward (10.7% vs 9.4%)
were significantly more common (P <.01) when labor was induced electively. The difference in cesarean delivery was
due to significantly more first-stage dystocia in the induced group. The difference
in neonatal admission could be attributed to a higher admission rate for maternal
convenience when the women had a cesarean delivery. Conclusion: When compared with labor of spontaneous onset, elective labor induction in nulliparous
women is associated with significantly more operative deliveries. Nulliparous women
should be informed about this before they submit to elective induction. (Am J Obstet
Gynecol 2002;186:240-4.)
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to American Journal of Obstetrics & GynecologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Induction of labor.in: Management of labor and delivery. : Blackwell Science, Oxford1997: 293-315
- Elective induction of labor at 39 weeks of gestation: a prospective randomized trial.J Obstet Gynaecol Res. 1999; 25: 33-37
- Elective induction of labor.Clin Obstet Gynecol. 1997; 40: 496-509
- Labour induction policy in hospitals of different levels of specialisation.Br J Obstet Gynaecol. 1993; 100: 310-315
- Large differences in obstetrical intervention rates among Dutch hospitals, even after adjustment for population differences.Eur J Obstet Gynecol Reprod Biol. 1996; 68: 97-103
- The epidemiology of labor induction: Arizona 1997.Am J Obstet Gynecol. 2000; 182: 1355-1362
- Epidural analgesia for low risk labour determines the rate of instrumental deliveries but not that of caesarean sections.J Obstet Gynaecol. 1998; 18: 25-29
- Elective induction of labour: a randomized prospective trial.Lancet. 1975; 1: 767-770
- Elective induction of labor as a risk factor for cesarean delivery among low-risk women at term.Obstet Gynecol. 2000; 95: 917-922
- Epidural analgesia in active management of labor.Acta Obstet Gynecol Scand. 1994; 73: 235-239
- Elective induction versus spontaneous labor: a retrospective study of complications and outcome.Am J Obstet Gynecol. 1992; 166: 1690-1697
- Risk of cesarean delivery with elective induction of labor at term in nulliparous women.Obstet Gynecol. 1999; 94: 600-607
- Induction of labor and the relationship to cesarean delivery: a review of 7001 consecutive inductions.Am J Obstet Gynecol. 1999; 180: 628-633
- Elective induction versus spontaneous labor: a case-control analysis of safety and efficacy.Obstet Gynecol. 1998; 92: 47-52
- Hazards and benefits of elective induction of labor.Am J Obstet Gynecol. 1984; 148: 579-585
- Inductie in Vlaanderen.in: : Jaarboek SPE, Brussels1995: 62-73
Article Info
Publication History
Accepted:
August 21,
2001
Received in revised form:
August 7,
2001
Received:
April 27,
2001
Footnotes
☆Reprint requests: H. Cammu, MD, Academic Hospital–Free University Brussels, Department of Gynecology, Andrology, and Obstetrics, Laarbeeklaan, 101, B-1090, Brussels, Belgium. E-mail: [email protected] .
Identification
Copyright
© 2002 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
