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Original Article

Risk Factors for Cesarean Delivery in Preterm, Term and Post-Term Patients Undergoing Induction of Labor with an Unfavorable Cervix

Ennen C.S.a · Bofill J.A.b · Magann E.F.a, c · Bass J.D.d · Chauhan S.P.e · Morrison J.C.b

Author affiliations

aObstetrics and Gynecology, Naval Medical Center Portsmouth, Portsmouth, Va., and bMaternal-Fetal Medicine Fellowship Program, University of Mississippi Medical Center, Jackson, Miss., USA; cObstetrics and Gynecology, University of Western Australia, Perth, W.A., Australia; dTennessee Department of Health, Nashville, Tenn., and eMaternal-Fetal Medicine, Aurora Health Care, West Allis, Wisc., USA

Related Articles for ""

Gynecol Obstet Invest 2009;67:113–117

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Article / Publication Details

First-Page Preview
Abstract of Original Article

Received: January 15, 2008
Accepted: July 22, 2008
Published online: October 30, 2008
Issue release date: February 2009

Number of Print Pages: 5
Number of Figures: 0
Number of Tables: 3

ISSN: 0378-7346 (Print)
eISSN: 1423-002X (Online)

For additional information: https://www.karger.com/GOI

Abstract

Background/Aims: To identify risk factors for cesarean delivery in patients with an unfavorable cervix undergoing an indicated induction of labor. Methods: This is a secondary analysis of combined data from three prospective randomized trials comparing cervical ripening methods in singleton pregnancies with an unfavorable cervix seeking to identify risk factors for cesarean delivery. Results: Nine hundred and five women underwent an induction of labor for a variety of indications. Gestational age ranged from 27.0–42.8 weeks (mean of 37.8 weeks) and initial Bishop’s score from 0–6 (mean 2.5). There were 613 vaginal deliveries (67.7%) and 292 cesarean deliveries (32.2%). Factors associated with an increased risk for cesarean delivery included nulliparous status, Bishop’s score ≤1, body mass index >40 and diabetes mellitus. Conclusions: Risk factors for cesarean delivery in women undergoing an indicated induction include a low Bishop’s score, high BMI, nulliparity and diabetes.

© 2008 S. Karger AG, Basel


References

  1. Martin JA, Hamilton BE, Sutton PD, Ventura SJ, Menacker F, Munson ML: Births: Final Data for 2003. Hyattsville, National Center for Health Statistics, National Vital Statistics Reports, 2003, p 54.
  2. Vrouenraets F, Roumen F, Dehing C, van den Akker E, Aarts M, Scheve E: Bishop score and risk of cesarean delivery after induction of labor in nulliparous women. Obstet Gynecol 2005;105:690–697.
  3. Maslow AS, Sweeny AL: Elective induction of labor as a risk factor for cesarean delivery among low-risk women at term. Obstet Gynecol 2000;95:917–922.
  4. Seyb ST, Berka RJ, Socol ML, Dooley SL: Risk of cesarean delivery with elective induction of labor at term in nulliparous women. Obstet Gynecol 1999;94:600–607.
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  7. Luthy DA, Malmgren JA, Zingheim RW: Cesarean delivery after elective induction in nulliparous women: the physician effect. Am J Obstet and Gynecol 2004;191:1511–1515.
  8. Heffner LJ: Impact of labor induction, gestational age, and maternal age on cesarean delivery rates. Obstet Gynecol 2003;102:287–293.
  9. Barrilleaux PS, Bofill JA, Terrone DA, Magann EF, May EL, Morrison JC: Cervical ripening and induction of labor with misoprostol, dinoprostone gel, and a Foley catheter: a randomized trial of 3 techniques. Am J Obstet Gynecol 2002;186:1124–1129.
  10. Alexander JM, McIntire DD, Leveno KJ: Prolonged pregnancy: induction of labor and cesarean births. Obstet Gynecol 2001;97:911–915.
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  12. Maslow AS, Sweeny AL: Elective induction of labor as a risk factor for cesarean delivery among low-risk women at term. Obstet Gynecol 2000;95:917–922.
  13. Nuthalapaty FS, Rouse DJ, Owen J: The association of maternal weight with cesarean risk, labor duration, and cervical dilation rate during labor induction. Obstet Gynecol 2004;103:452–456.
  14. Cnattingius R, Hoglund B, Kieler H: Emergency cesarean delivery in induction of labor: an evaluation of risk factors. Acta Obstet Gynecol Scand 2005;84:456–462.
  15. Yeast JD, Jones A, Poskin M: Induction of labor and the relationship to cesarean delivery: a review of 7001 consecutive inductions. Am J Obstet Gynecol 1999;180:628–633.
  16. Peregrine E, O’Brien P, Omar R, Jauniaux E: Clinical and ultrasound parameters to predict the risk of cesarean delivery after induction of labor. Obstet Gynecol 2006;107:227–233.

Article / Publication Details

First-Page Preview
Abstract of Original Article

Received: January 15, 2008
Accepted: July 22, 2008
Published online: October 30, 2008
Issue release date: February 2009

Number of Print Pages: 5
Number of Figures: 0
Number of Tables: 3

ISSN: 0378-7346 (Print)
eISSN: 1423-002X (Online)

For additional information: https://www.karger.com/GOI


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