Document Detail


Physicians who induce labor for fetal macrosomia do not reduce cesarean delivery rates.
MedLine Citation:
PMID:  11324367     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine whether obstetricians with high rates of induction for the indication of fetal macrosomia had higher or lower cesarean section rates. STUDY DESIGN: Data were analyzed from 1432 deliveries with birthweights > 4000 g. Four physician populations were identified: a faculty service and three groups of private practitioners with induction rates 20% to 40%, 40% to 60% and > 60%. The average cesarean section rate was determined for each group as well as the percentage of each group's deliveries occurring before 39 weeks, at 39, at 40, and after 40 weeks. In addition, the relative risk of cesarean delivery was calculated for the entire study population. RESULTS: No correlation was found between the rate of induction of labor and the rate of cesarean section. Delivery of nulliparous and multiparous patients after 40 weeks carried an increased risk of cesarean section. Delivery of multiparous patients before 39 weeks did also. Obstetricians with induction rates > 40% significantly decreased the incidence of delivery after 40 weeks, which lowered their cesarean section rates, but no net lowering occurred because of increased rate of cesarean section < 39 weeks. CONCLUSION: A fetal weight of 4000 g or more is not an indication for induction of labor. For multiparous patients, induction at 38 weeks or before is associated with an increased rate of cesarean delivery.
Authors:
T J Horrigan
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of perinatology : official journal of the California Perinatal Association     Volume:  21     ISSN:  0743-8346     ISO Abbreviation:  J Perinatol     Publication Date:  2001 Mar 
Date Detail:
Created Date:  2001-04-27     Completed Date:  2001-09-06     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8501884     Medline TA:  J Perinatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  93-6     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, Medical College of Ohio, 3120 Glendale Avenue, Toledo, OH 43614, USA.
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MeSH Terms
Descriptor/Qualifier:
Cesarean Section / statistics & numerical data*
Female
Fetal Macrosomia*
Humans
Labor, Induced*
Parity
Pregnancy
Regression Analysis
Retrospective Studies

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


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