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Related Concept Videos

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External Cephalic Version: Is it an Effective and Safe Procedure?
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Reducing the cesarean delivery rate.

Elliot M Levine1, Leah N Delfinado2, Stephen Locher3

  • 1University of Illinois at Chicago, Chicago, IL, USA; Advocate Illinois Masonic Medical Center, Chicago, IL, USA.

European Journal of Obstetrics, Gynecology, and Reproductive Biology
|May 22, 2021
PubMed
Summary
This summary is machine-generated.

Induction of labor in nulliparous women significantly increases cesarean delivery rates compared to spontaneous labor. This finding is crucial for decisions regarding labor induction, particularly when medically unnecessary.

Keywords:
Bishop scoreCesarean deliveryIncidenceLabor inductionPerinatal lossPlacenta accreteRelative risk

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Area of Science:

  • Obstetrics and Gynecology
  • Maternal-Fetal Medicine
  • Perinatal Outcomes

Background:

  • Rising cesarean delivery rates are linked to increased maternal morbidity.
  • Elective induction of labor has also seen a notable increase.
  • Understanding factors influencing cesarean rates is critical for maternal health.

Purpose of the Study:

  • To compare cesarean delivery rates between induced and spontaneous labor.
  • To analyze outcomes in nulliparous, term, singleton, vertex-presenting women.
  • To assess neonatal morbidity associated with labor induction versus spontaneous labor.

Main Methods:

  • Retrospective cohort study over seven years at a single institution.
  • Analysis of cesarean delivery rates across different term gestational ages.
  • Neonatal morbidity assessed using the 5-minute Apgar score (< 5).

Main Results:

  • A statistically significant higher cesarean delivery rate was observed for induced labor compared to spontaneous labor at all term gestational ages (P < 0.001).
  • Indications for induction (elective vs. medically indicated) were detailed.
  • No significant difference in neonatal morbidity was found between induced and spontaneous labor groups based on the 5-minute Apgar score.

Conclusions:

  • Spontaneous labor is associated with a significantly lower cesarean delivery rate than induced labor in nulliparous women.
  • The decision for labor induction in nulliparous women, especially without medical indication, warrants careful consideration due to increased cesarean risk.
  • Findings support prioritizing spontaneous labor when feasible to potentially reduce cesarean delivery rates.