Obstet Gynecol Sci.  2019 Jan;62(1):19-26. 10.5468/ogs.2019.62.1.19.

Benefits and risks of induction of labor at 39 or more weeks in uncomplicated nulliparous women: a retrospective, observational study

• Kim HI
• Choo SP
• Han SW
• Kim EH

• KMID: 2430926
• DOI: http://doi.org/10.5468/ogs.2019.62.1.19

Abstract

OBJECTIVE
To critically compare the benefits and risks of labor induction versus spontaneous labor in uncomplicated nulliparous women at 39 or more weeks of gestation.
METHODS
We conducted a retrospective, observational study of 237 nulliparous women who were at 39 or more weeks of a singleton pregnancy with vertex presentation and intact membranes. We compared maternal outcomes including the Cesarean section rate and neonatal outcomes in the induced labor and spontaneous labor groups.
RESULTS
Among the 237 women, 199 delivered vaginally (84.0%). The spontaneous labor group and induced labor group had a similar incidence of Cesarean delivery (17.7% vs. 12.3%, P=0.300). The length of stay and blood loss during delivery were also similar between the groups (4.3±1.5 vs. 3.9±1.5 days and 1.9±1.3 vs. 1.8±1.0 mg/sL, respectively; all P > 0.05). Regarding neonatal outcomes, the rate of meconium-stained amniotic fluid, Apgar score < 7 at 5 minutes, and intubation rate were similar between the groups (18.9% vs. 24.7%, 7.9% vs. 4.1%, and 6.1% vs. 4.4%, respectively, all P > 0.05). Only the neonatal intensive care unit admission rate was significantly lower in the induction group than in the spontaneous labor group (28.0% vs. 13.2%, P=0.001).
CONCLUSION
Maternal adverse outcomes of labor induction at 39 weeks of gestation were similar to those in a spontaneous labor group in uncomplicated nulliparous women. Neonatal adverse events were also similar between the groups. It may be acceptable to schedule labor induction as long as 7 days before the estimated date, even when the indication is only relative.

Keyword

Induced labor; Cesarean section; Newborn infant; Postpartum period; Obstetric delivery

MeSH Terms

Amniotic Fluid
Apgar Score
Appointments and Schedules
Cesarean Section
Delivery, Obstetric
Female
Humans
Incidence
Infant, Newborn
Intensive Care, Neonatal
Intubation
Labor, Induced
Length of Stay
Membranes
Observational Study*
Postpartum Period
Pregnancy
Retrospective Studies*
Risk Assessment*

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