Complications of labor induction among multiparous women in a community-based hospital system

Department of Obstetrics & Gynecology , University of California, Irvine, Irvine, California, United States
American journal of obstetrics and gynecology (Impact Factor: 4.7). 10/2007; 197(3):241.e1-7; discussion 322-3, e1-4. DOI: 10.1016/j.ajog.2006.12.027
Source: PubMed


The purpose of this study was to examine complications of labor induction compared to spontaneous labor in multiparas.
This was a retrospective cohort study of multiparous women with live, singleton pregnancies at term, who had no contraindications to labor or labor induction. Cesarean delivery was the primary outcome.
Of the study subjects, 7208 experienced spontaneous labor, 2190 underwent labor induction with oxytocin, and 239 underwent labor induction requiring cervical ripening agents. Oxytocin-induced multiparas were 37% more likely to require cesarean compared to those with spontaneous labor (OR, 1.37; 95% CI, 1.10-1.71) and nearly 3 times more likely to undergo cesarean when cervical ripening agents were used (OR, 2.82; 95% CI, 1.84-4.53). Women requiring cervical ripening were also 10 times more likely to spend more than 12 hours in labor than those with spontaneous labor.
Multiparas undergoing labor induction are at increased risk for obstetric complications compared to spontaneous labor.


Available from: Deborah A Wing
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    • "Induction of labour with an unfavorable cervix is associated with prolonged labour compared to spontaneous onset of labour or induction of labour with a favorable cervix. Also an increase in instrumental deliveries and a higher rate of caesarean sections are seen [1-3]. To increase the success of labour induction it is essential to achieve cervical ripening in women with an unfavorable cervix. "
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    • "This increase in pain is indicated by the increase in epidural dosage among women with induced labor [19]. Secondly, labor is induced more often when there are complications, and complications themselves are associated with epidural use [20]. Finally, we speculate women who elect to have labor induced are likely more comfortable with other medical interventions, such as an epidural, further contributing to the observed association between induction of labor and epidural use. "
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