Induction of labor and cesarean delivery by gestational age
ABSTRACT Studies of cesarean delivery (CD) rates among women undergoing induction of labor (IOL) often compare such women to women experiencing spontaneous labor at similar gestational ages. We sought to examine the association between IOL at various gestational ages and CD, accounting for the effect of increased gestational age among the comparison group who were managed expectantly.
We conducted a retrospective cohort study of all term, singleton, cephalic presentation pregnancies delivered at our institution over 15 years excluding cesarean deliveries before labor. For each gestational age of induction, we created a comparison group of women who were undelivered at that gestational age, and who experienced labor at some future gestational age.
In women undergoing IOL at 38 weeks gestation, the CD rate was 11.9% as compared to 13.3% (P = .42) of women beyond 38 weeks gestation. The CD rate for induction of labor compared to ongoing pregnancy was 14.3% versus 15.0% (P = .62) at 39 weeks, 20.4% versus 19.0% (P = .41) at 40 weeks, and 24.3% versus 26.0% (P = .39) at 41 weeks. When controlling for potential confounding, there was a higher rate of CD among women with expectant management beyond 38 weeks (adjusted odds ratio [AOR] 1.80; 95% CI 1.29-2.53), 39 weeks (1.39; 95% CI 1.08-1.80), and 40 weeks (AOR 1.27; 95% CI 1.00-1.62).
Our findings suggest that IOL may not increase a woman's risk of CD when compared to expectant management. While this question has been addressed prospectively at 41 weeks gestation, it requires further examination at earlier gestations and among various subgroups.
- SourceAvailable from: ncbi.nlm.nih.govThe Annals of Family Medicine 07/2007; 5(4):292-3. DOI:10.1370/afm.730 · 4.57 Impact Factor
Conference Paper: Project application to a PLC continuous casting control system[Show abstract] [Hide abstract]
ABSTRACT: The author describes the development of different estimates of the programmable control (PLC) system used for the Stelco Inc., Hilton Works continuous casters. He discusses: main costs to look for; accumulation of data to prepare an appropriation estimate; bidding process; check estimate to follow any changes, enhancements, and installation factors; fair cost estimates to cover field changes; and final percentage analysis. It is concluded that enhancements to PLC systems are very costly and should be looked at in the earlier stages of the project. Drive and digital control systems are an essential part of the PLC system, and, while evaluating the cost of PLCs, emphasis should also be placed on their costsProgrammable Control and Automation Technology Conference and Exhibition, 1988. Conference Proceedings., Fourth Annual Canadian; 11/1988