Document Detail

Risk of cesarean delivery in nulliparous women at greater than 41 weeks' gestational age with an unengaged vertex.
MedLine Citation:
PMID:  14749648     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: The purpose of this study was to determine whether an unengaged vertex significantly increased the risk of cesarean delivery in nulliparous patients at 41 weeks or greater. STUDY DESIGN: The medical records from all nulliparous patients greater than 41 weeks' gestation delivered at a single institution were reviewed. Patients undergoing both spontaneous and induced labor were included. Multivariate analyses were used to compare the influence of admission fetal station versus induction of labor on the risk of cesarean delivery. RESULTS: Four hundred forty-eight nulliparous women at greater than 41 weeks' gestation were delivered at our institution during the study period. Sixty-two percent of these patients underwent induction of labor. There was a statistically significant increase in cesarean delivery rate compared with station (6% of patients at -1 station, 20% at -2 station, 43% at -3 station, and 77% at -4 station; P=.001). Compared with patients with an engaged vertex, patients with an unengaged vertex had 12.4 times the risk of cesarean delivery. Most of the cesarean deliveries were performed for failure to progress. On the basis of multivariate analysis, the odds of cesarean delivery were better predicted by fetal station than induction of labor. CONCLUSION: Nulliparous patients at 41 weeks or greater with an unengaged vertex are 12.4 times more likely to be delivered by cesarean section than a patient with an engaged vertex.
Karen S Shin; Katherine L Brubaker; Lynn M Ackerson
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  190     ISSN:  0002-9378     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  2004 Jan 
Date Detail:
Created Date:  2004-01-29     Completed Date:  2004-02-25     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  129-34     Citation Subset:  AIM; IM    
Department of Obstetrics and Gynecology, Kaiser Permanente Medical Center, Santa Clara, CA, USA.
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MeSH Terms
Cesarean Section*
Cohort Studies
Labor Presentation*
Multivariate Analysis
Odds Ratio
Pregnancy, Prolonged*
Retrospective Studies
Risk Factors

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

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