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Published on: January 17, 2019
Induction of labor in a contemporary obstetric cohort
S Katherine Laughon1, Jun Zhang, Jagteshwar Grewal
1Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA.
Objective:
We sought to describe details of labor induction, including precursors and methods, and associated vaginal delivery rates.
Study Design:
This was a retrospective cohort study of 208,695 electronic medical records from 19 hospitals across the United States, 2002 through 2008.
Results:
Induction occurred in 42.9% of nulliparas and 31.8% of multiparas and elective or no recorded indication for induction at term occurred in 35.5% and 44.1%, respectively. Elective induction at term in multiparas was highly successful (vaginal delivery 97%) compared to nulliparas (76.2%). For all precursors, cesarean delivery was more common in nulliparas in the latent compared to active phase of labor. Regardless of method, vaginal delivery rates were higher with a ripe vs unripe cervix, particularly for multiparas (86.6-100%).
Conclusion:
Induction of labor was a common obstetric intervention. Selecting appropriate candidates and waiting longer for labor to progress into the active phase would make an impact on decreasing the national cesarean delivery rate.
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