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Management of prolonged pregnancy by induction with a Foley catheter.

AbstractOBJECTIVES:
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.
DESIGN:
Retrospective study.
SETTING:
Helsinki University Hospital.
SAMPLE:
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.
METHODS:
Maternal and neonatal characteristics of women with uncomplicated singleton pregnancy of ≥41(+5) weeks of gestation were analyzed.
MAIN OUTCOME MEASURES:
Cesarean delivery rates, maternal and neonatal morbidity.
RESULTS:
The cesarean delivery rate was 30.7% (n = 93/303) in women with labor induction and 4.8% (12/250) in women with spontaneous onset of labor (p < 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%, p = 0.2). There were no differences in maternal intrapartum or postpartum infection rates or adverse neonatal outcomes between the groups.
CONCLUSIONS:
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.
AuthorsHeidi Kruit, Oskari Heikinheimo, Veli-Matti Ulander, Ansa Aitokallio-Tallberg, Irmeli Nupponen, Jorma Paavonen, Leena Rahkonen
JournalActa obstetricia et gynecologica Scandinavica (Acta Obstet Gynecol Scand) Vol. 94 Issue 6 Pg. 608-14 (Jun 2015) ISSN: 1600-0412 [Electronic] United States
PMID25761517 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Copyright© 2015 Nordic Federation of Societies of Obstetrics and Gynecology.
Topics
  • Adult
  • Cesarean Section (statistics & numerical data)
  • Female
  • Finland
  • Humans
  • Infant, Newborn
  • Labor, Induced (instrumentation)
  • Pregnancy
  • Pregnancy Outcome
  • Pregnancy, Prolonged (therapy)
  • Retrospective Studies
  • Risk Factors
  • Urinary Catheterization

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