Document Detail


Outcomes of induction of labor after one prior cesarean.
MedLine Citation:
PMID:  17267822     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To compare pregnancy outcomes in women with one prior low-transverse cesarean delivery after induction of labor with pregnancy outcomes after spontaneous labor. METHODS: This study is an analysis of women with one prior low-transverse cesarean and a singleton gestation who underwent a trial of labor and who were enrolled in a 4-year prospective observational study. Pregnancy outcomes were evaluated according to whether a woman underwent spontaneous labor or labor induction. RESULTS: Among the 11,778 women studied, vaginal delivery was less likely after induction of labor both in women without and with a prior vaginal delivery (51% versus 65%, P<.001; and 83% versus 88%, P<.001). An increased risk of uterine rupture after labor induction was found only in women with no prior vaginal delivery (1.5% versus 0.8%, P=.02; and 0.6% versus 0.4%, P=.42). Blood transfusion, venous thromboembolism, and hysterectomy were also more common with induction among women without a prior vaginal delivery. No measure of perinatal morbidity was associated with labor induction. An unfavorable cervix at labor induction was not associated with any adverse outcomes except an increased risk of cesarean delivery. CONCLUSION: Induction of labor in the study population is associated with an increased risk of cesarean delivery in all women with an unfavorable cervix, a statistically significant, albeit clinically small, increase in maternal morbidity in women with no prior vaginal delivery, and no appreciable increase in perinatal morbidity. LEVEL OF EVIDENCE: II.
Authors:
William A Grobman; Sharon Gilbert; Mark B Landon; Catherine Y Spong; Kenneth J Leveno; Dwight J Rouse; Michael W Varner; Atef H Moawad; Steve N Caritis; Margaret Harper; Ronald J Wapner; Yoram Sorokin; Menachem Miodovnik; Marshall Carpenter; Mary J O'Sullivan; Baha M Sibai; Oded Langer; John M Thorp; Susan M Ramin; Brian M Mercer
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  109     ISSN:  0029-7844     ISO Abbreviation:  Obstet Gynecol     Publication Date:  2007 Feb 
Date Detail:
Created Date:  2007-02-01     Completed Date:  2007-02-27     Revised Date:  2009-10-26    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  262-9     Citation Subset:  AIM; IM    
Affiliation:
Departments of Obstetrics and Gynecology at Northwestern University, 333 East Superior Street, Chicago, IL 60611, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Case-Control Studies
Cohort Studies
Female
Humans
Labor, Induced*
Labor, Obstetric*
Obstetric Labor Complications / epidemiology*
Pregnancy
Pregnancy Outcome*
Reproductive History
Vaginal Birth after Cesarean*
Grant Support
ID/Acronym/Agency:
HD 21410/HD/NICHD NIH HHS; HD 21414/HD/NICHD NIH HHS; HD 27860/HD/NICHD NIH HHS; HD 27861/HD/NICHD NIH HHS; HD 27869/HD/NICHD NIH HHS; HD 27905/HD/NICHD NIH HHS; HD 27915/HD/NICHD NIH HHS; HD 27917/HD/NICHD NIH HHS; HD 34116/HD/NICHD NIH HHS; HD 34122/HD/NICHD NIH HHS; HD 34146/HD/NICHD NIH HHS; HD 34208/HD/NICHD NIH HHS; HD 34210/HD/NICHD NIH HHS; HD 36801/HD/NICHD NIH HHS; HD 40485/HD/NICHD NIH HHS; HD 40500/HD/NICHD NIH HHS; HD 40512/HD/NICHD NIH HHS; HD 40544/HD/NICHD NIH HHS; HD 40545/HD/NICHD NIH HHS; HD 40560/HD/NICHD NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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