Related Experiment Video
Updated: Apr 27, 2026
External Cephalic Version: Is it an Effective and Safe Procedure?
Published on: June 6, 2020
Predictors of cesarean delivery in women undergoing labor induction with a Foley balloon
Shani Delaney1, Brian L Shaffer, Yvonne W Cheng
1Department of Obstetrics and Gynecology, University of Washington , Seattle, WA , USA .
Objective:
To examine predictive characteristics for cesarean delivery (CD) in women undergoing labor induction with a Foley balloon (FB).
Methods:
A secondary analysis of a randomized, double-blind, control trial examining labor induction with a transcervical 30 mL or 60 mL FB. One-hundred ninety-nine women with term, vertex, singleton pregnancies and Bishop score < 5 were randomized to receive a transcervical 30 mL or 60 mL FB. Mode of delivery, labor complications and neonatal outcomes were recorded. A multivariable model was performed to determine predictive characteristics for CD.
Results:
Increasing maternal age (p = 0.04), nulliparity (p =0.002) and chorioamnionitis (p < 0.001) were significantly associated with an elevated risk for CD. Nulliparity was associated in an almost 4-fold increased CD risk (relative risk [RR]: 3.88; 95% confidence interval [CI]: 1.22-12.3). Women aged ≥ 40 years, had an almost 3-fold increased risk of CD as compared to women aged 20-29 (RR: 2.91; 95% CI: 1.36-6.19) years. Chorioamnionitis was associated with nearly a 2-fold increased risk for CD (RR: 1.87; 95% CI: 1.06-3.32). A gestational age of ≥ 41 weeks, prostaglandin use during induction and induction indication did not affect mode of delivery.
Conclusion:
In patients undergoing labor induction with a FB, increasing maternal age, nulliparity and chorioamnionitis are associated with an elevated risk for CD.
