Elective induction of labor: A prospective observational study

Dögl, Malin; Romundstad, Pål Richard; Berntzen, Line Dahlgaard; Fremgaarden, Oliv Camilla; Kirial, Katrine; Kjøllesdal, Anne Molne; Nygaard, Benedicte S.; Robberstad, Line; Steen, Thorbjørn B.; Tappert, Christian; Torkildsen, Cecilie Fredvik; Værnesbranden, Magdalena R.; Vietheer, Alexander; Heimstad, Runa

doi:10.1371/journal.pone.0208098

Cited by 17 publications

(16 citation statements)

References 21 publications

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“…The group “maternal request” was surprisingly low with 3.5% of all inductions and we found a low CS rate both in the nulliparous term cephalic and the previous CS group. This is lower than previously reported 23 . The distinction between “maternal request” or “medical problem” can be a fine one, especially when considering mental health and pregnancy complaints.…”

Section: Discussioncontrasting

confidence: 57%

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Induction of labor and nulliparity: A nationwide clinical practice pilot evaluation

Sørbye

Oppegaard

Weeks

et al. 2020

Acta Obstet Gynecol Scand

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Introduction: Induction of labor has become an increasingly common obstetric procedure, but in nulliparous women or women with a previous cesarean section, it can pose a clinical challenge. Despite an overall expansion of medical indications for labor induction, there is little international consensus regarding the criteria for induction, or for the recommended methods among nulliparous women. In this light, we assessed variations in the practice of induction of labor among 21 birth units in a nationwide cohort of women with no prior vaginal birth. Material and methods: We carried out a prospective observational pilot study of women with induced labor and no prior vaginal birth, across 21 Norwegian birth units. We registered induction indications, methods and outcomes from 1 September to 31 December 2018 using a web-based case record form. Women were grouped into "Nulliparous term cephalic", "Previous cesarean section" and "Other Robson" (Robson groups 6, 7, 8 or 10). Results: More than 98% of eligible women (n=1818) were included and a wide variety of methods was used for induction of labor. In nulliparous term cephalic pregnancies, cesarean section rates ranged from 11.1% to 40.6% between birth units, whereas in the previous cesarean section group, rates ranged from 22.7% to 67.5%. The indications "large fetus" and "other fetal" indications were associated with the highest cesarean rates. Failed inductions and failure to progress in labor contributed most to the cesarean rates. Uterine rupture occurred in two women (0.11%), both in the previous cesarean section group. In neonates, 1.6% had Apgar <7 at 5 minutes, and 0.4% had an umbilical artery pH <7.00. Conclusions: Cesarean rates and applied methods for induction of labor varied widely in this nationwide cohort of women without a prior vaginal birth. Neonatal outcomes were similar to those of normal birth populations. Results could indicate the need to move towards more standardized induction protocols associated with optimal outcomes for mother and baby. | 1701 SØRBYE Et al.

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Section: Discussioncontrasting

confidence: 57%

“…This is lower than previously reported. 23 The distinction between "maternal request" or "medical problem" can be a fine one, especially when considering mental health and pregnancy complaints. However, this finding indicates a restrictive attitude among providers, in contrast to upcoming trends elsewhere.…”

Section: Discussionmentioning

confidence: 99%

Induction of labor and nulliparity: A nationwide clinical practice pilot evaluation

Sørbye

Oppegaard

Weeks

et al. 2020

Acta Obstet Gynecol Scand

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“…In truth, the concept of elective induction has increasingly been defined as an induction at term, without an apparent clinical reason, in order to improve maternal and perinatal outcomes. To my knowledge, the first reference dates back to 1947 19 , and since then many observational studies 20– 28 and some randomized studies (revised in 29, 30 ) have been published. The latest contribution is that of the Maternal–Fetal Medicine Units Network which, in August 2018 31 , published the results of a multicenter trial that included 6,106 low-risk women randomized to receive IOL at 39 0 –39 4 weeks or expectant management.…”

Section: Precursors For Inductionmentioning

confidence: 99%

Recent advances in the induction of labor

Marconi

2019

F1000Res

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The rate of labor induction is steadily increasing and, in industrialized countries, approximately one out of four pregnant women has their labor induced. Induction of labor should be considered when the benefits of prompt vaginal delivery outweigh the maternal and/or fetal risks of waiting for the spontaneous onset of labor. However, this procedure is not free of risks, which include an increase in operative vaginal or caesarean delivery and excessive uterine activity with risk of fetal heart rate abnormalities. A search for “Induction of Labor” retrieves more than 18,000 citations from 1844 to the present day. The aim of this review is to summarize the controversies concerning the indications, the methods, and the tools for evaluating the success of the procedure, with an emphasis on the scientific evidence behind each.

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“…LMP has its limitations since dating may be difficult because of imperfect recall, irregular menstrual cycles, bleeding in early pregnancy, and lactation amenorrhea It is increasingly acknowledged that ultrasound-based EDD may help improve diagnosis and treatment of preterm birth and help reduce the associated perinatal mortality (Marchant et al, 2012). Studies have shown that post-term pregnancy is one of the leading indications for labor induction (Whitworth et al, 2015;Dogl et al, 2018). Therefore, accurate pregnancy dating is crucial for the diagnosis and management of post-term pregnancy.…”

Section: Introductionmentioning

confidence: 99%

Agreement between estimated date of delivery determined by last menstrual period and ultrasound: A prospective cohort of Tanzanian women

Nielsen¹,

Wu²,

Rogathi³

et al. 2021

Int. J. Nurs. Midwifery

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In Tanzania, the estimated delivery date (EDD) is mainly determined by the last menstrual period (LMP), presumably leading to inaccurate estimates with a falsely high proportion of post-term and preterm deliveries. The study aimed to compare EDD determination by LMP and ultrasound in pregnant Tanzanian women and examine how the dating method affects the proportions born preterm, at term, and post-term and assess how maternal characteristics relate to wrongly EDD determination by LMP. 1123 women attending antenatal care in Moshi, Tanzania were included. Gestational age (GA) at birth was calculated according to LMP and ultrasound separately. The distribution of preterm (GA<259 days), term (GA 259-294 days), and post-term (GA >294 days) births was examined separately for LMP and ultrasound. According to LMP, 17.0% of deliveries were preterm and 17.6% post-term. According to ultrasound, 7.7% of deliveries were preterm and 3.4% post-term. Unplanned pregnancy was associated with an increased odds ratio of 3.06 (95% CI: 1.91-4.91) for preterm delivery when LMP was used for EDD determination instead of ultrasound. Parity 3+ was associated with an increased odds ratio of 2.12 (95%CI: 1.16-3.89) for post-term delivery when EDD was assessed by LMP. LMP based EDD increased the preterm birth rate two times and the post-term birth rate five times compared to ultrasound-based EDD.

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Elective induction of labor: A prospective observational study

Cited by 17 publications

References 21 publications

Induction of labor and nulliparity: A nationwide clinical practice pilot evaluation

Induction of labor and nulliparity: A nationwide clinical practice pilot evaluation

Recent advances in the induction of labor

Agreement between estimated date of delivery determined by last menstrual period and ultrasound: A prospective cohort of Tanzanian women

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