MedStar Authors catalog › Details for: Preterm induction of labor: predictors of vaginal delivery and labor curves.
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Preterm induction of labor: predictors of vaginal delivery and labor curves.

by Huang, Chun Chih; Miodovnik, Menachem; Landy, Helain J; Umans, Jason G.
Citation: American Journal of Obstetrics & Gynecology. 212(1):91.e1-7, 2015 Jan..Journal: American journal of obstetrics and gynecology.ISSN: 0002-9378.Full author list: Feghali M; Timofeev J; Huang CC; Driggers R; Miodovnik M; Landy HJ; Umans JG.UI/PMID: 25068566.Subject(s): Adult | Delivery, Obstetric | Female | Forecasting | Humans | *Labor, Induced | Obstetric Labor, Premature | Pregnancy | Pregnancy Complications | Retrospective StudiesInstitution(s): MedStar Health Research Institute | MedStar Washington Hospital CenterDepartment(s): Obstetrics and Gynecology, Maternal-Fetal MedicineActivity type: Journal Article.Medline article type(s): Journal Article | Research Support, N.I.H., ExtramuralOnline resources: Click here to access online Digital Object Identifier: http://dx.doi.org/10.1016/j.ajog.2014.07.035 (Click here) Abbreviated citation: Am J Obstet Gynecol. 212(1):91.e1-7, 2015 Jan.Local Holdings: Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006.Abstract: OBJECTIVE: The purpose of this study was to evaluate the labor curves of patients who undergo preterm induction of labor (IOL) and to assess possible predictors of vaginal delivery (VD).Abstract: STUDY DESIGN: Data from the National Institute of Child Health and Human Development Consortium on Safe Labor were analyzed. A total of 6555 women who underwent medically indicated IOL at <37 weeks of gestation were included in this analysis. Patients were divided into 4 groups based on gestational age (GA): group A, 24-27+6 weeks; B, 28-30+6 weeks; C, 31-33+6 weeks; and D, 34-36+6 weeks. Pregnant women with a contraindication to VD, IOL >37 weeks of gestation, and without data from cervical examination on admission were excluded. Analysis of variance was used to assess differences between GA groups. Multiple logistic regression was used to assess predictors of VD. A repeated measures analysis was used to determine average labor curves.Abstract: RESULTS: Rates of vaginal live births increased with GA, from 35% (group A) to 76% (group D). Parous women (odds ratio, 6.78; 95% confidence interval, 6.38-7.21) and those with a favorable cervix at the start of IOL (odds ratio, 2.35; 95% confidence interval, 2.23-2.48) were more likely to deliver vaginally. Analysis of labor curves in nulliparous women showed shorter duration of labor with increasing GA; the active phase of labor was, however, similar across all GAs.Abstract: CONCLUSION: Most women who undergo medically indicated preterm IOL between 24 and 36+6 weeks of gestation deliver vaginally. The strongest predictor of VD was parity. Preterm IOL had a limited influence on estimated labor curves across GAs.Copyright � 2015 Elsevier Inc. All rights reserved.

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