Transactions of the Twenty-Sixth Annual Meeting of the Society for Maternal-Fetal MedicineInduction of labor and cesarean delivery by gestational age
Section snippets
Material and methods
We conducted a retrospective cohort study of all term, singleton, cephalic deliveries at the University of California, San Francisco (UCSF) from 1986 to 2001. Women with a previous cesarean or who experienced a cesarean in the current pregnancy without labor or for an indication other than dystocia or nonreassuring fetal assessment (eg, placenta previa, breech, HSV) were excluded. Because elective induction was not the practice at the institution, we did not exclude high-risk patients with
Results
During the study period, 19,377 women met study inclusion criteria. Of these, 2,932 (15.1%) underwent induction of labor and 16,445 (84.9%) experienced spontaneous onset of labor. The two groups differed by every characteristic considered as a potential confounder except for level of education (Table I). Overall, the cesarean delivery rate among the women who were induced was 20.6% as compared to 10.9% among those with spontaneous labor (P < .001).
In the comparison that is commonly made, when
Comment
Consistent with the existing literature, we found that both overall and when compared to women of the same gestational age, women undergoing induction of labor had a higher cesarean delivery rate than women in spontaneous labor. However, both overall and particularly among nulliparas, there was generally a lower cesarean delivery rate among women who were induced as compared to those managed expectantly who delivered at greater gestational ages.
The latter finding is in stark contrast to most
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2020, American Journal of Obstetrics and GynecologyCitation Excerpt :An increase in costs among women undergoing induction, similar in magnitude to those documented by Seyb et al, was found in other studies in the United States as well as in Canada.6,7,9 Such studies, however, may give very different results from those performed with the clinically relevant comparator of expectant management.10,11 Indeed, our analysis refutes the belief that elective induction of labor is uniformly more resource intensive than expectant management.
Elective induction of labor: friend or foe?
2020, Seminars in PerinatologyElective induction of labor at 39 weeks compared with expectant management: a meta-analysis of cohort studies
2019, American Journal of Obstetrics and Gynecology
Dr Caughey is supported by the National Institute of Child Health and Human Development, grant # HD01262 as a Women's Reproductive Health Research Scholar.
Presented at the Twenty-Sixth Annual Meeting of the Society for Maternal Fetal Medicine, Miami, FL, January 30-February 4, 2006.