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Labor induction and augmentation in women with multiple sclerosis.
1Department of Medicine (Division of Neurology), Faculty of Medicine, University of British Columbia, Canada.
Multiple Sclerosis (Houndmills, Basingstoke, England)
|February 7, 2013
Summary
Women with multiple sclerosis (MS) did not show increased rates of labor induction or augmentation. However, higher disability scores (EDSS) in MS patients were linked to increased labor induction needs.
Area of Science:
- Obstetrics and Gynecology
- Neurology
- Reproductive Health
Background:
- Fatigue and pelvic organ dysfunction are common in women with multiple sclerosis (MS).
- These symptoms may prolong labor and increase the need for interventions like labor induction or augmentation.
Purpose of the Study:
- To investigate the association between MS and clinical factors (disease duration, EDSS) with labor induction/augmentation.
- To compare labor intervention rates in women with MS versus the general population.
Main Methods:
- Data linkage between the British Columbia (BC) MS database and the BC Perinatal Database Registry (1998-2009).
- Multivariable models analyzed attempted vaginal deliveries in women with MS (n=381) and controls (n=2615).
- Examined labor induction and augmentation rates based on MS status, disease duration, and Expanded Disability Status Scale (EDSS) scores.
Main Results:
- Multiple sclerosis (MS) itself was not significantly associated with labor induction or augmentation.
- Women with MS were more likely to require multiple methods for labor induction (OR=1.94).
- Higher EDSS scores correlated with an increased risk of labor induction (p=0.04), but not augmentation.
Conclusions:
- While MS status alone doesn't predict induction/augmentation needs, higher disability (EDSS) suggests a greater need for labor induction.
- Increased intervention may be necessary for women with MS experiencing greater physical disability.
