Open AccessInduction of labor and the risk for emergency cesarean section in nulliparous and multiparous women
Author(s) -
THORSELL MALIN,
LYRENÄS SVEN,
ANDOLF ELLIKA,
KAIJSER MAGNUS
Publication year - 2011
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.1111/j.1600-0412.2011.01213.x
Subject(s) - medicine , obstetrics , gestational age , pregnancy , labor induction , singleton , retrospective cohort study , gynecology , population , relative risk , cohort study , risk factor , medical record , confidence interval , surgery , oxytocin , genetics , environmental health , pathology , biology
Objective. To assess the risk for emergency cesarean section among women in whom labor was induced in gestational week ≥41 and to evaluate if parity and mode of induction affected this association. Design. Hospital‐based retrospective cohort study. Population . Singleton pregnancies delivered after ≥41 gestational weeks at Danderyd Hospital, Stockholm, Sweden, during 2002–2006. Material and methods. Of 23 030 singleton pregnancies meeting the entry criteria, 881 were induced with a Bishop score of <7. Obstetric outcome was assessed through linkage with the Swedish Medical Birth Registry and a local obstetrical database containing information from patients’ medical files. Results were adjusted for body mass index, age and the use of epidural analgesia. Main outcome measure . Risk for emergency cesarean section. Results. Among women who were induced, the proportions delivered by emergency cesarean section were 42% for nulliparous and 14% for multiparous. Compared to spontaneous onset, this corresponded to a more than threefold increase in risk for nulliparous women (OR 3.34, 95%CI 2.77–4.04) and an almost twofold increase in risk for multiparous women (OR 1.94, 95%CI 1.24–3.02). There was no significant difference in risk for emergency cesarean section between the two methods of induction (PGE 2 and transcervical catheter). Conclusions. Compared to spontaneous onset of delivery, induction of labor is associated with an increased risk for emergency cesarean section both among nulliparous and multiparous women. When labor is induced, the high risk for emergency cesarean must be kept in mind.