Predicting the Antepartum Factors Resulted in Failed Labor Induction in Nulliparous Term Pregnancies

Objectives: This study aimed to evaluate the feasibility of using a computerized machine to predict a successful normal vaginal delivery and determine the antepartum factors involved in failed labor induction in nulliparous term women. Methods: This prospective cohort study was conducted in Yas Hospital affiliated with Tehran University of Medical Sciences from 2017 to 2019. The data used for the computerized system were obtained during the admission of the term nulliparous women with singleton pregnancy in cephalic presentation. The cesarean delivery rate, as well as maternal and perinatal outcomes, were evaluated. The input variables were maternal age, gravida, gestational age at birth, necessity and type of labor induction, presentation of the baby at birth, Bishop Score, fetal weight, and fetal head circumference, and maternal disorders. The outputs were vaginal deliveries or cesarean sections. Results: The rate of cesarean section was 41.8% (n = 287). Higher maternal age (OR = 1.044, P = 0.018, CI = 1.007 - 1.082), lower Bishop Score (OR = 0.192, P < 0.001, CI = 0.139 - 0.256) and non-occiput anterior position (OR = 82.194, P < 0.001, CI = 15.888 - 425.214) were significantly associated with failed induction. Conclusions: The result of this study may be beneficial for healthcare providers to predict the delivery route, the risk of labor induction failure and make a personal decision according to each individual.

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Effectiveness and safety of dinoprostona and cook’s balloon for labour induction in pregnants with small for gestational age fetuses

Obstetrics & Gynecology International Journal ◽

10.15406/ogij.2020.11.00514 ◽

2020 ◽

Vol 11 (4) ◽

Author(s):

Jorge Duro Gómez ◽

Marta Porras Lucena ◽

Vendrell Aranda Celia María

Keyword(s):

Pregnant Women ◽

Gestational Age ◽

Small For Gestational Age ◽

Retrospective Cohort ◽

Perinatal Outcomes ◽

Labor Induction ◽

Labour Induction ◽

Vaginal Deliveries ◽

Time To Delivery

Objectives: To compare the effectiveness (hours until delivery) and safety (rate of vaginal deliveries and caesarean sections, use of oxytocin and perinatal outcomes) of dinoprostone and Cook's balloon as a method of labor induction in pregnant women with fetuses with an estimated weight below the 10th percentile and normal Doppler. Methods: retrospective cohort review of pregnant women with small for gestational age fetuses and induced with both methods in Reina Sofía Hospital, Cordoba, Spain from 2014 to 2018. The main outcome was time until delivery. Descriptive characteristics, obstetric and perinatal outcomes were analyzed. 322 pregnant women were induced: 204 women were induced with Cook's balloon (CB) and 118 with dinoprostone (DIN). RESULTS: Dinoprostone decreases the time until delivery (28.86 vs. 24.32 hours with CB and DIN, respectively, p<0.0001) and the use of oxytocin (79.7% vs 54.2% in CB and DIN group; p<0,01), as compared to Cook's balloon. No differences were observed in the rate of caesarean sections and vaginal deliveries, as well as in perinatal results. Conclusion: DIN reduces the time to delivery compared to CB with a lower need for oxytocin. Moreover, without worse perinatal outcomes.

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Incidence of cesarean delivery after induction of labour with dinoprostone gel at term in nulliparous women with unfavourable bishops score

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20170956 ◽

2017 ◽

Vol 6 (4) ◽

pp. 1253

Author(s):

Kalpana Mehta ◽

Dhanesh Kumar ◽

Dharmendra Singh Fathepuriya ◽

Leena Verma

Keyword(s):

Cesarean Section ◽

Vaginal Delivery ◽

Previous History ◽

Fetal Distress ◽

Induction Of Labour ◽

Normal Vaginal Delivery ◽

Bishop Score ◽

Nulliparous Women ◽

History Of ◽

The Mean

Background: The aim of induction of labour is to achieve vaginal delivery in advance of the normal timing of parturition and to avoid operative delivery. The objective was to study the incidence of instrumental delivery and cesarean section in nulliparous women with unfavourable bishops score at term.Methods: This study was conducted on 200 patients in nulliparous women with unfavourable bishop score, cephalic presentation and no previous history of abortion.Results: The most frequent cause of induction of labour was postdatism (47.5%) followed by PIH (25.5%) and PROM (13%). 143 (71.5%) women had normal vaginal delivery whereas in 54 women (27%) cesarean section was done. 2 women (1%) had forceps application for delivery and remaining 1 women (0.5%) had ventouse delivery. Out of 200 patients 9 had maternal complication of induction of labour.Conclusions: In present study 71.5% women had normal vaginal delivery, 27% had cesarean section. Mean bishop score at induction was 3.31 which improved to 4.0 after 12 hours of gel instillation. The mean induction to delivery interval was 13.38 hrs in present study, 54.5% patients were delivered within 12 hours of gel instillation in this study. Most common indication of cesarean section was failed progress followed by fetal distress.

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Increased length of active labor is associated with adverse perinatal outcomes among nulliparous women undergoing labor induction

The Journal of Maternal-Fetal & Neonatal Medicine ◽

10.1080/14767058.2020.1797670 ◽

2020 ◽

pp. 1-7

Author(s):

Hayley J. MacKinnon ◽

Melissa A. Schiff ◽

Kara K. Hoppe ◽

Thomas J. Benedetti ◽

Shani Delaney

Keyword(s):

Perinatal Outcomes ◽

Labor Induction ◽

Nulliparous Women ◽

Active Labor ◽

Adverse Perinatal Outcomes

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359: Increased length of active labor is associated with adverse perinatal outcomes among nulliparous women undergoing labor induction

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2017.10.295 ◽

2018 ◽

Vol 218 (1) ◽

pp. S223

Author(s):

Hayley J. MacKinnon ◽

Melissa A. Schiff ◽

Kara K. Hoppe ◽

Thomas J. Benedetti ◽

Shani Delaney

Keyword(s):

Perinatal Outcomes ◽

Labor Induction ◽

Nulliparous Women ◽

Active Labor ◽

Adverse Perinatal Outcomes

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Cesarean Delivery Rates Among Nulliparous Women With Advanced Maternal Age Undergoing Labor Induction [32l]

Obstetrics and Gynecology ◽

10.1097/01.aog.0000533571.27003.f2 ◽

2018 ◽

Vol 131 ◽

pp. 137S-138S

Author(s):

Amrin Khander ◽

Catherine Bigelow ◽

Brittany Robles ◽

Clara Koo ◽

Miriam Klahr ◽

...

Keyword(s):

Cesarean Delivery ◽

Maternal Age ◽

Advanced Maternal Age ◽

Labor Induction ◽

Nulliparous Women

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Predictors of Success Of Vaginal Birth After Previous Cesarean Section

Journal of Gandhara Medical and Dental Science ◽

10.37762/jgmds.4-1.27 ◽

2017 ◽

Vol 4 (1) ◽

pp. 13-17

Author(s):

Maimoona Qadir ◽

Sohail Amir

Keyword(s):

Cesarean Section ◽

Vaginal Delivery ◽

Gestational Age ◽

Maternal Age ◽

Vaginal Birth ◽

Bishop Score ◽

Predictors Of Success ◽

Singleton Pregnancy ◽

History Of ◽

Previous Cesarean

BACKGROUNDWomen eligible for vaginal birth after cesarean section (VBAC) have lower morbidity rates than women who undergo subsequent elective cesarean sections.Objective:To identify the obstetric parameters those influence the success of vaginal delivery in women with previous cesarean section.METHODOLOGYThis descriptive cross sectional study was conducted at Gynaecology and Obstetrics Department of Khyber Teaching Hospital, Peshawar from 1st May 2015 to 31st April 2016.Inclusion criteria was all women of any age or parity presenting at >36weeks gestational age, with singleton pregnancy, vertex presentation, estimated fetal weight of 2.5 -3.5kg and documented previous lower uterine segment cesarean section for a non recurrent cause. Five predictors of success of vaginal birth after previous cesarean including maternal age, gestational age, and history of vaginal delivery, onset of labor and bishop score were evaluated in each patient.RESULTSOut of 100 women, 64 had VBAC and 36 had cesarean section. Fifty five were booked and 45 were non booked. Total women with history of VBAC were 24, out of these 16(66%) had VBAC and 8(33%) had repeat cesarean section. Ninety three had spontaneous onset of labor whereas 7 were induced,88 patients had Bishop score >5,out of these 61(69%) ended in VBAC and 27(30.6%) had cesarean section. The most common age group where VBAC occurred in majority was 25- 35 years. Thirty nine (61%) women had period of gestation between 38weeks to 39weeks+6days. Mean maternal age was 29.42 + 3.54 yearsCONCLUSIONHistory of vaginal delivery, spontaneous sonset of labor and Bishop score >5 are the factors which are associated with more chances of vaginal delivery after cesarean section.

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The Association between Cervical Exam after Ripening with Foley Balloon Catheter and Outcomes of Nulliparous Labor Induction

American Journal of Perinatology ◽

10.1055/s-0038-1635091 ◽

2018 ◽

Vol 35 (10) ◽

pp. 1001-1005 ◽

Cited By ~ 2

Author(s):

Anna Palatnik ◽

Danielle Peress ◽

William Grobman ◽

Ashley Battarbee

Keyword(s):

Confidence Interval ◽

Vaginal Delivery ◽

Foley Catheter ◽

Multivariable Analysis ◽

Balloon Catheter ◽

Labor Induction ◽

Cervical Ripening ◽

Bishop Score ◽

Labor Duration ◽

Nulliparous Women

Objective Evaluate the association between cervical examination after ripening with Foley catheter and labor induction outcomes. Materials and Methods In this retrospective cohort, nulliparous women with singleton, viable gestation undergoing cervical ripening with Foley catheter were compared based on cervical status after catheter removal or expulsion: favorable (modified Bishop score ≥ 5) or unfavorable (score < 5). Bivariable and multivariable analyses were performed to determine whether cervical examination postripening was associated with time to delivery and chance of vaginal delivery. Results A total of 774 women were eligible. Women with favorable examination postripening had lower body mass index (BMI) and more favorable admission cervical examination. The frequency of vaginal delivery was higher in women with favorable cervical examination postripening (57.9% versus 46.8%, p < 0.01). Median durations from Foley removal or expulsion to complete dilation (8.6 h versus 11.5 h) and vaginal delivery (10.4 h versus 13.2 h) were shorter for women with favorable cervical examination postripening (p < 0.001). In multivariable analysis, favorable examination postripening remained associated with vaginal delivery (adjusted odds ratio 1.39, 95% confidence interval 1.04–1.87), and time to vaginal delivery (adjusted hazard ratio 1.39, 95% confidence interval 1.13–1.70). Conclusion A favorable modified Bishop score after cervical ripening with Foley balloon catheter is associated with higher chance of vaginal delivery and shorter labor duration.

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Relationship between maternal age and labor induction duration and outcomes in nulliparous women

The Journal of Maternal-Fetal & Neonatal Medicine ◽

10.1080/14767058.2021.1932807 ◽

2021 ◽

pp. 1-8

Author(s):

Elizabeth Nicole Teal ◽

Stephanie L. Gaw ◽

Phinnara Has ◽

Adam K. Lewkowitz

Keyword(s):

Maternal Age ◽

Labor Induction ◽

Nulliparous Women

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Maternal and fetal outcomes with the use of prostaglandins E2 as a cervical ripening agent for induction of labour

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20195597 ◽

2019 ◽

Vol 9 (1) ◽

pp. 44

Author(s):

Shagun Gupta ◽

Neha Kuntal ◽

Virendra Kumar Gupta

Keyword(s):

Neonatal Morbidity ◽

Modern Medicine ◽

Labor Induction ◽

Induction Of Labour ◽

Cervical Ripening ◽

P Value ◽

Bishop Score ◽

Singleton Pregnancy ◽

Group 2 ◽

Group 1

Background: In modern medicine induction of labour is required in patients for a good feto-maternal outcome. PGE2 is a prostaglandin analogue which has been used as a cervical ripening agent to improve bishops score. Objective of this study was to evaluate the efficacy of intravaginal PGE2 gel as a cervical ripening agent in unfavourable cervix for induction of labor and any complications associated with its use.Methods: This study comprised of 90 women who required labor induction. Singleton pregnancy above 37 weeks, live intrauterine fetus, Cephalic presentation, Bishop score of 1-6, reactive FHR pattern were included. Women who required only single induction were categorized as Group 1. Those requiring more than one dose after reassessment of bishops scoring at 6, 12 and 18 hours belonged to Group 2.Results: Group1 had more of younger population below 30 years consisting more primigravidas with > 80% women having gestational age of > 39 weeks. Most common indication for induction of labour in both groups was post-dated pregnancy. 65 patients received one dose of cerviprime gel forming Group 1. In Group 2, 72% received 2 doses and 28%, 3 doses of gel. Initial bishops score mean was 4.2 in Group 1 and 4.1 in Group 2. Mean change in bishop score was analysed after 6, 12, and 18 hours of instillations of PGE2 gel. Significant p value was obtained in all groups requiring one, two and three doses of gel. In Group 1, 12.3% and in Group 2, 16% had LSCS. Maternal side effects were minimal and neonatal outcome was good.Conclusions: The study showed that intravaginal application of PGE2 is effective, safe and acceptable method as a cervical ripening agent for labor induction in women with poor bishops score. It reduces caesarean delivery rate without increasing maternal and neonatal morbidity.

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