Analysis of the set of primiparous women with induced labor


Authors: Lenka Krajčiová;  Michael Halaška;  Iva Mikysková;  Eva Homolková;  Borek Sehnal
Authors‘ workplace: Gynekologicko-porodnická klinika 1. LF UK a Nemocnice Na Bulovce, Praha
Published in: Prakt Gyn 2015; 19(2): 89-95
Category: Gynecology and Obstetrics: Original Article

Overview

Objective:
To analyse effect of induced labor in primiparous women after completed 41st gestation week without any other pathology.

Design:
Retrospective clinical study.

Setting:
Department of Gynaecology and Obstetrics, First Faculty of Medicine, Charles Univesity in Prague, Hospital Na Bulovce.

Material:
Altogether 6 317 women delivered at Hospital Na Bulovce in Prague between years 2011–2013. In 203 primiparous women after completed 41st gestation week, labor was induced by prostaglandin dinoproston. The control group consisted of 291 primi­parae with spontaneus onset of labor after the term.

Methods:
We compared the groups in respect to patient´s age, parity, total duration of labor, total blood loss, frequency of different ways of delivery, frequency of analgesia, frequency of diverse delivery injuries, manual removal of placenta and uterine hypotonia, neonatal outcomes (Apgar score of newborns, and the pH of umbilical arterial and vein blood). Data were retrospectively obtained from the medical documentation and statistically processed.

Results:
We proved significantly higher frequency of Caesarean sections (21,2 % vs 11,0 %, p < 0,002), statistically significant higher blood loss (341 ml vs 314 ml, p = 0,002), and frequency of epidural analgesia applications (25,1 % vs 11,7 %, p < 0,001) in the study group. Other analysed para­meters were similar in both groups. Expected effect of age more than 35 years on frequency of Caesarean section was not proved in the study group.

Conclusion:
We found a substantially higher frequency of Cesarean sections in primiparous women with induced labor. The duration of delivery and the frequency of uterine hypotonia were similar as in the control group. The pharmacological labor induction is a strong risk factor for Caesarean delivery in primiparous women with induced labor for postterm pregnancy.

Key words:
Caesarean section – dinoproston – forceps – induced labor – postterm pregnancy – primipara – prostaglandins – vacuum extraction


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Labels
Paediatric gynaecology Gynaecology and obstetrics Reproduction medicine

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