Induction of labor at 41 weeks of pregnancy among primiparas with an unfavorable Bishop score
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To determine the rate and factors associated with the successful Induction of Labor (IOL) in nulliparous patients undergoing scheduled IOL at 41 weeks of gestational age (GA) with an unfavorable cervix.
This was a retrospective analysis that included nulliparous patients who presented to the Labor and Delivery unit at the Bronx Lebanon Hospital Center between 2011 and 2012 for elective IOL at 41 weeks of GA. The Bishop score was assessed upon admission and IOL agents were used in compliance with ACOG guidelines in different combinations, based on the obstetrical team preference.
Labor and Delivery Unit of the Bronx Lebanon Hospital.
Nulliparous patients with 41 weeks of pregnancy for elective induction of labor.
Seventy-six patients were included in the study. GA was confirmed using a combination of the last menstrual period and a dating sonogram during pregnancy.
This was a retrospective chart review that included nulliparous patients who presented to the Labor and Delivery unit at the Bronx Lebanon Hospital Center between October 2011 and October 2012 for elective IOL at 41 weeks of gestational age with an unfavorable cervix defined as a Bishop score of 6 or less.
Main outcome measures
The overall successful rate of IOL in a combination of different maternal factors with different agents for induction in nulliparous patients undergoing scheduled IOL with an unfavorable Bishop score at 41 weeks of GA was 51.32 %.
Factors associated with successful IOL were younger age [22.3 years vs. 25.1(p = 0.015)], lower BMI [25 vs. 28.1(p = 0.46)] and lower maternal weight [64.75 kg vs. 74.02 (p = 0.28)]. Maternal height was not a contributing factor; the artificial rupture of membranes, epidural anesthesia and the prostaglandins used did not contribute. Use of cervical balloon and oxytocin was associated with failed IOL.
Patients undergoing IOL at 41 weeks with an unfavorable cervix had a successful rate of 51.32 %. Younger maternal age, lower weight, and lower BMI were associated with successful IOL.
KeywordsInduction of labor Nulliparous 41 weeks Unfavorable cervix
Centricity Perinatal GE healthcare, General Electric 2013. We wish to thank the Labor and Delivery staff of the Bronx Lebanon Hospital for their help and support to this study.
Conflict of interest
All the authors declare that have no conflict of interest.
The Institutional Review Board of the Bronx Lebanon Hospital approved our study on the 27 March 2013, IRB # 12 13 12 03 and no informed consent was required.
- 1.Gabbe S, Niebyl J, Galan H, Jauniaux E, Landon M, Simpson J et al (2012) Obstet: norm and probl pregnancies. 6th edn. Saunders Elsevier, Philadelphia, Chapter 14, Abnormal Labor and Induction of labor, p. 287–310.Google Scholar
- 2.American College of Obstetricians and Gynecologists: Induction of Labor. Practice bulletin number 107, August 2009Google Scholar
- 3.Martin JA, Hamilton BE, Sutton PD, Ventura SJ, Menacker F, Kirmeyer S, Mathews TJ et al (2009) Division of vital statistics births: final data for 2006. Natl Vital Stat Rep 57:1–102Google Scholar
- 10.Khan NB, Ahmed I, Malik A et al (2012) Factors associated with a failed induction of labour in a secondary care hospital. JPMA 62(1):6–10Google Scholar
- 11.Vaknin Z, Kurzweil Y, Sherman D (2010) Foley catheter balloon vs locally applied prostaglandins for cervical ripening and labor induction: a systematic review and metaanalysis. Am J Obstet Gynecol 04:038Google Scholar