Indicated labor induction with vaginal prostaglandin E2 increases the risk of cesarean section even in multiparous women with no previous cesarean section
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A. Ben-Haroush
Abstract
Aims: To evaluate the impact of induction of labor with vaginal tablets of prostaglandin E2 on the rate of cesarean section (CS), and to identify possible predictors of successful vaginal delivery. Methods: 1541 consecutive women admitted for induction of labor with vaginal tablets of PGE2 were retrospectively compared with 574 consecutive women with spontaneous onset of labor. Results: Maternal age, nulliparity, previous CS, gestational age, and birth weight were similar in the study and control groups. The CS rate was twofold higher in the study group (20.7% vs 10.6%). CS rates in the study and control groups were 26.9% and 12.8% for the nulliparous women, and 11.2% and 5.1% for the multiparous women with no previous CS. Neither group had major maternal or fetal complications. A logistic regression model and stepwise analysis showed that nulliparity, previous CS, maternal age, number of PGE2 applications, birth weight, and the induction of labor by itself were independent significant risk factors for increased CS rate. Conclusions: Induction of labor with vaginal PGE2 tablets results in a vaginal delivery rate of 79.3%, with apparently no serious maternal or fetal complications. Nulliparity, and previous CS are the most significant risk factors for increased CS rate. However, even after these risk factors are excluded and controlling for possible predictors for CS, PGE2 induction is independently associated with a twofold increase in CS rate, most often because of labor dystocia.
Copyright © 2004 by Walter de Gruyter GmbH & Co. KG
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Articles in the same Issue
- Editorial
- The role of ultrasonography in recognizing the cause of fetal cerebral ventriculomegaly
- A kick from within – fetal movement counting and the cancelled progress in antenatal care
- DNA microarrays detect the expression of apoptosis-related genes in preeclamptic placentas
- Indicated labor induction with vaginal prostaglandin E2 increases the risk of cesarean section even in multiparous women with no previous cesarean section
- Cervical immunoglobulin A and altered vaginal flora in pregnant women with threatened preter delivery
- Multiple courses of antenatal corticosteroid therapy in patients with preterm premature rupture of membranes
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- Fetal and early postnatal magnetic resonance imaging – is there a difference?
- Bone turnover markers and bone strength during the first weeks of life in very low birth weight premature infants
- The ponderal index in triplets: I. Relationship to small for gestational age neonates
- The ponderal index in triplets: II. Gestational age-related patterns of neonatal weights and lengths
- The ponderal index in triplets: III. Association with birth weight discordance
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- Intratracheal albumin reduces interleukin-8 in tracheobronchial aspirates in piglets after meconium aspiration
- The pulmonary paradox in premature infants: in-utero infected lungs do better than those with accelerated maturation
- Congenital syphilis: unique clinical presentation in three preterm newborns
- Twin-to-twin transfusion syndrome complicated by spontaneous mid-trimester uterine rupture
- Persistent pulmonary hypertension in a premature newborn after 16 hours of antenatal indomethacin exposure
- Congress Calendar
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