Document Detail

An audit about labour induction, using prostaglandin, in women with a scarred uterus.
MedLine Citation:
PMID:  22836816     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: Induction of labour after a previous caesarean section is still controversial. We aim to analyse, in a population of women who have a uterine scar, the maternal, foetal and neonatal complications in relation to the mode of labour and delivery.
STUDY DESIGN: Retrospective analysis of collected data from all the singleton deliveries of patients with a scarred uterus (N=798), admitted to the hospital between August 2006 and March 2009.
OUTCOMES: maternal and perinatal complications.
RESULTS: Among 798 singleton deliveries, 36.1% had a spontaneous labour, 12.6% a prostaglandin-induced labour and 2.9% an ocytocin-induced labour, and 48.4% had an elective caesarean section. The chance of delivering vaginally was respectively 84.4% for those who had a spontaneous labour, 75.2% for those who were induced using prostaglandin, 82.6% after induction using ocytocin. There were eight uterine ruptures, four after spontaneous labour (1.4%), two after prostaglandin induction (2%) and two at the time of an iterative caesarean section (0.5%). There were no differences between groups, except the risk of haemorrhage (17.4% after spontaneously induced labour, 34.8% after ocytocin, 17.8% after prostaglandin and 44.6% after iterative caesarean section; p<0.005) and the neonatal admissions when analysed by intention to treat only (8.3% after spontaneously induced labour, 9.1% after ocytocin, 12% after prostaglandin and 16.8% after iterative caesarean section; p<0.009).
CONCLUSION: Although no increase in maternal or perinatal outcome was observed in relation to prostaglandin-induced labour after caesarean section, this study is too underpowered to exclude an increased risk.
Alexandra Cogan; Patricia Barlow; Nordine Benali; Daniel Murillo; Yannick Manigart; Julie Belhomme; Serge Rozenberg
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Publication Detail:
Type:  Journal Article     Date:  2012-07-27
Journal Detail:
Title:  Archives of gynecology and obstetrics     Volume:  286     ISSN:  1432-0711     ISO Abbreviation:  Arch. Gynecol. Obstet.     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-11-06     Completed Date:  2013-05-13     Revised Date:  2014-07-31    
Medline Journal Info:
Nlm Unique ID:  8710213     Medline TA:  Arch Gynecol Obstet     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  1399-406     Citation Subset:  IM    
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MeSH Terms
Cesarean Section / adverse effects
Chi-Square Distribution
Cicatrix / complications
Intensive Care, Neonatal
Intention to Treat Analysis
Labor, Induced / adverse effects*,  methods
Labor, Obstetric
Logistic Models
Medical Audit
Obstetric Labor Complications / chemically induced*
Oxytocics / administration & dosage*,  adverse effects
Oxytocin / administration & dosage,  adverse effects
Postoperative Hemorrhage / etiology*
Prostaglandins / administration & dosage*,  adverse effects
Retrospective Studies
Uterine Rupture / etiology
Uterus / pathology,  surgery
Reg. No./Substance:
0/Oxytocics; 0/Prostaglandins; 50-56-6/Oxytocin

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

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