title: Comparison of labor progression between induced and noninduced multiparous women.
abstract: OBJECTIVE
  The incidence of labor induction is rising rapidly in the United States. Among multiparas, labor is often followed with traditional labor curves derived from noninduced pregnancies. We sought to determine how labor progression of multiparous women who presented in spontaneous labor differed from those who were electively induced with and from those induced without preinduction cervical ripening.
  
  
  METHODS
  We analyzed data on all low-risk multiparous women with an elective induction or spontaneous onset of labor between 37(+0) and 40(+6) weeks of gestation from January 2002 to March 2004 at a single institution. The median duration of labor by each centimeter of cervical dilatation and the risk of cesarean delivery were computed for 61 women with preinduction cervical ripening and oxytocin induction, 735 women with oxytocin induction, and 1,885 women with a spontaneous onset of labor. An intracervical Foley catheter was used to ripen the cervix.
  
  
  RESULTS
  Those women who experienced electively induced labor without cervical ripening had a shorter active phase of labor than did those admitted in spontaneous labor (99 minutes in induced labor versus 161 minutes in spontaneous labor, P < .001). However, the cesarean delivery rate was elevated in the induction group (3.9% versus 2.3%, P < .05). Women who underwent preinduction cervical ripening also had a shorter active phase than those admitted in spontaneous labor (109 minutes versus 161 minutes, P = .01).
  
  
  CONCLUSIONS
  The pattern of labor progression differs for women with an electively induced labor without cervical ripening compared with those who present with spontaneous onset of labor.
authors.affiliation: Department of Obstetrics and Gynecology, Christiana Care Health Services, Newark, Delaware 19718, USA. Mjoffman@Christianacare.org
authors.forename: Matthew K
authors.initials: MK
authors.lastname: Hoffman
authors.forename: Anjel
authors.initials: A
authors.lastname: Vahratian
authors.forename: Anthony C
authors.initials: AC
authors.lastname: Sciscione
authors.forename: James F
authors.initials: JF
authors.lastname: Troendle
authors.forename: Jun
authors.initials: J
authors.lastname: Zhang
mesh_terms: D000328:Adult; D002404:Catheterization; D020070:Cervical Ripening; D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D007745:Labor Onset; D007751:Labor, Induced; D010120:Oxytocics; D010121:Oxytocin; D010298:Parity; D011247:Pregnancy; D012189:Retrospective Studies; D013997:Time Factors
chemical_list: D010120:Oxytocics; D010121:Oxytocin