Induction Shortens Active Phase of Labor but Increases Cesarean Risk
Reuters Health Information 2006. © 2006 Reuters Ltd.
NEW YORK (Reuters Health) May 15 - Elective induction of labor significantly
shortens the active phase - by an hour, on average - but nearly doubles the
risk of cesarean section, researchers report in the May issue of Obstetrics
and Gynecology.
Dr. Matthew K. Hoffman of Christiana Care Health Services in Newark,
Delaware, and colleagues reviewed the outcome of labor progression in 9447
women with singleton pregnancies admitted for delivery in their institution
between January 2002 and March 2004. Of the total cases, 5056 women were
multiparas.
Dr. Hoffman focused on 2681 low-risk multiparas. This group was further
divided into 735 women who had oxytocin induction without cervical
pre-ripening, 61 women who had pre-induction cervical ripening followed by
oxytocin induction of labor, and 1885 women with a spontaneous onset of
labor, which served as a comparison group.
Women who had labor induction without cervical ripening had the shortest
length of active labor, at 99 minutes, while those who had induction with
cervical pre-ripening had an active phase of labor of 109 minutes. Women who
went into labor spontaneously had the longest active phase of labor, at 161
minutes (p < 0.001).
Women who were induced had a more rapid progression to active labor than
those with a spontaneous onset. However, women who underwent pre-induction
cervical ripening had a slower progression to active labor than those with
spontaneous onset.
The cesarean delivery rate was significantly higher at 3.9% with induction
of labor compared with 2.3% in those who had a spontaneous labor.
Dr. Hoffman and his group note that physicians should be aware of the
differences in the pattern of labor progression among multiparas and
nulliparas who are undergoing inductions, Dr. Hoffman writes.
Obstet Gynecol 2006;107:1029-1034.
Leanne Wynne
Midwife in charge of "Women's Business"
Mildura Aboriginal Health Service Mob 0418 371862
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