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Outcomes of induction of labour in nulliparous women at 38 to 39 weeks pregnancy by clinical indication: An observational study
Author(s) -
de Vries Bradley Stephen,
Barratt Alexandra,
McGeechan Kevin,
Tooher Jane,
Wong Ebony,
Phipps Hala,
Gordon Adrienne,
Hyett Jon Anthony
Publication year - 2019
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1111/ajo.12930
Subject(s) - medicine , obstetrics , observational study , gestation , pregnancy , caesarean section , gestational age , labor induction , population , fetus , gynecology , vaginal delivery , environmental health , pathology , biology , oxytocin , genetics
Background Knowledge of the outcomes of induction of labour for different indications is sparse. Aims To describe the mode of birth and other outcomes for nulliparous women induced at 38–39 weeks gestational age by indication for induction of labour. Material and methods This was a retrospective observational study in a tertiary referral hospital, and a metropolitan teaching hospital in Sydney. The study population was nulliparous women with induction of labour at 38 or 39 completed weeks of pregnancy and a singleton, cephalic presenting baby planning a vaginal birth, from 2009 to 2016. The indication for induction of labour was classified into 12 groups. Mode of birth and other maternal and perinatal outcomes were described in each group, for women who spontaneously laboured at 38 or 39 weeks, and for women who gave birth from 40 completed weeks onward. The main outcome measure was mode of birth. Results There were 3330 women with induction of labour at 38 or 39 weeks gestation. Rates of vaginal birth varied widely, ranging from 54% when the indication for induction was suspected large fetus, to 82% when the indication was suspected fetal compromise, and was 74% overall. Indications for caesarean delivery also varied by indication for induction. Among women giving birth ≥40 weeks gestational age, 75% had a vaginal birth. Conclusions In nulliparous women, rates of vaginal birth following induction of labour at 38 or 39 weeks gestation vary widely according to the indication for induction. These data are useful for antenatal counselling.