Labor induction after fetal death. A retrospective analysis.
OBJECTIVE
To describe the delivery outcomes in patients with stillborn infants after labor induction versus spontaneous onset of labor.


METHODS
A retrospective chart review was performed of singleton pregnancies complicated by fetal death over a three-year period when awaiting spontaneous onset of labor was a common practice. Exclusion criteria were prior multiple cesarean deliveries, placenta previa, preeclampsia or suspected abruptio placentae. Outcome measures included time spent in the labor and delivery unit and rates of maternal hemorrhagic morbidity and endomyometritis.


RESULTS
Two hundred eight patients, 100 patients undergoing labor induction and 108 with spontaneous onset of labor, met the study criteria. Patients delivering after induction spent a longer time in the labor and delivery unit (13.7 versus 4.4 hours). The endomyometritis rate was higher in the spontaneous labor group (6% versus 1%). There were no differences in the frequency of postpartum hemorrhage, retained placenta or need for blood transfusion.


CONCLUSIONS
Induction following diagnosis of fetal death is safe and may reduce maternal infectious morbidity.
Salamat
Sharon M
SM
Division of Maternal-Fetal Medicine (R-136), Department of Obstetrics and Gynecology, University of Miami School of Medicine, 1611 NW 12th Avenue, Miami, FL 33136, USA. ssalamat@med.miami.edu
Landy
Helain J
HJ
O'Sullivan
Mary J
MJ
D000328:Adult; D036861:Delivery, Obstetric / Q000379:methods; D005260:Female; D005313:Fetal Death; D005500:Follow-Up Studies; D006801:Humans; D007751:Labor, Induced / Q000379:methods* / Q000706:statistics & numerical data*; D007744:Obstetric Labor Complications / Q000175:diagnosis / Q000453:epidemiology; D011247:Pregnancy; D011336:Probability; D012189:Retrospective Studies; D018570:Risk Assessment