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Elective induction of labor and the risk of cesarean section in low-risk parous women: a cohort study
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi. (Obstetrisk forskning/Högberg)
Department of Medicine, Clinical Epidemiology Unit, Karolinska Institute, Stockholm, Sweden.
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi. (Obstetrisk forskning/Högberg)
2013 (Engelska)Ingår i: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 92, nr 2, s. 198-203Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

OBJECTIVE:

To estimate the association between elective induction of labor and cesarean section in low-risk parous women, and to assess if the association is influenced by induction method.

DESIGN:

Cohort study.

SETTING:

University hospital in Sweden. Population Parous women without pregnancy complications or previous cesarean section, and with a planned vaginal term (37-41 weeks), singleton birth, in vertex position were included.

METHODS:

Information was collected from a local database containing prospectively entered antenatal and delivery data. Odds ratios for cesarean section were calculated using generalized estimating equations logistic regression and adjusted for parity, maternal age, gestational length, birthweight, use of epidural anesthesia and year of birth.

MAIN OUTCOME MEASURE:

Emergency cesarean section.

RESULTS:

Among 7973 pregnancies that fulfilled the inclusion criteria, 343 (4%) had an elective induction of labor. Intravenous oxytocin was administered in 5% of these inductions, amniotomy was performed in 62%, and a cervical ripening agent was used in 33%. Electively induced labor more than doubled the risk of cesarean section compared with spontaneous labor onset (OR 2.5, 95% 1.4-4.2) and this risk was more than tripled when cervical ripening was used (OR 3.6, 95% confidence interval 1.7-7.6).

CONCLUSIONS:

In low-risk parous women, electively induced labor has an increased risk of emergency cesarean section compared with spontaneous onset labor. This risk increase is more pronounced if cervical ripening agents are required. Women need to be counseled about these risks before elective induction of delivery is decided.

Ort, förlag, år, upplaga, sidor
2013. Vol. 92, nr 2, s. 198-203
Nationell ämneskategori
Medicin och hälsovetenskap
Identifikatorer
URN: urn:nbn:se:uu:diva-187920DOI: 10.1111/aogs.12043ISI: 000313914200012PubMedID: 23157554OAI: oai:DiVA.org:uu-187920DiVA, id: diva2:576081
Tillgänglig från: 2012-12-12 Skapad: 2012-12-12 Senast uppdaterad: 2018-01-24Bibliografiskt granskad

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Jonsson, MariaWikström, Anna-Karin
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