Management of prolonged pregnancy by induction with a Foley catheter. (3rd April 2015)

• Record Type: Journal Article
• Authors: Kruit, Heidi; Heikinheimo, Oskari; Ulander, Veli‐Matti; Aitokallio‐Tallberg, Ansa; Nupponen, Irmeli; Paavonen, Jorma; Rahkonen, Leena
• Is Part Of: Acta obstetricia et gynecologica Scandinavica. Volume 94:Number 6(2015)
• Page Start: 608
• Page End: 614
• Publication Date: 2015-04-03
• Subjects: Gynecology -- Periodicals; Pregnancy -- Periodicals; Obstetrics -- Periodicals; 618.05
• DOI: 10.1111/aogs.12632
• Languages: English
• ISSNs: 0001-6349

Abstract

<abstract abstract-type="main" id="aogs12632-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="aogs12632-sec-0001" sec-type="section"> <title>Objectives</title> <p>To describe labor outcomes in women with prolonged pregnancy and induction of labor with a Foley catheter, as compared with women with spontaneous onset of labor.</p> </sec> <sec id="aogs12632-sec-0002" sec-type="section"> <title>Design</title> <p>Retrospective study.</p> </sec> <sec id="aogs12632-sec-0003" sec-type="section"> <title>Setting</title> <p>Helsinki University Hospital.</p> </sec> <sec id="aogs12632-sec-0004" sec-type="section"> <title>Sample</title> <p>553 women with uncomplicated prolonged pregnancies between January 2011 and January 2012, divided into 303 women (54.8%) with Foley catheter induction and 250 (45.2%) with spontaneous labor.</p> </sec> <sec id="aogs12632-sec-0005" sec-type="section"> <title>Methods</title> <p>Maternal and neonatal characteristics of women with uncomplicated singleton pregnancy of ≥41<sup>+5</sup> weeks of gestation were analyzed.</p> </sec> <sec id="aogs12632-sec-0006" sec-type="section"> <title>Main outcome measures</title> <p>Cesarean delivery rates, maternal and neonatal morbidity.</p> </sec> <sec id="aogs12632-sec-0007" sec-type="section"> <title>Results</title> <p>The cesarean delivery rate was 30.7% (<italic>n </italic>=<italic> </italic>93/303) in women with labor induction and 4.8% (12/250) in women with spontaneous onset of labor (<italic>p </italic>< 0.001). The cesarean delivery rate was 37.3% (91/244) among nulliparous women with labor induction and 8.7% (11/126) among women with spontaneous labor, a sixfold increased risk (odds ratio 6.2). Among parous women, cesarean section rates were low and not significantly different (3.4% vs. 0.8%, <italic>p </italic>= 0.2). There were no differences in maternal intrapartum or postpartum infection rates or adverse neonatal outcomes between the groups.</p> </sec> <sec id="aogs12632-sec-0008" sec-type="section"> <title>Conclusions</title> <p>Foley catheter induction of labor in prolonged pregnancy did not increase maternal or perinatal morbidity compared with spontaneous onset of labor but was associated with a considerably increased cesarean section rate, particularly among nulliparous women.</p> </sec> </abstract>