title: Outcome of induced deliveries in growth-restricted fetuses: second thoughts about the vaginal option.
abstract: OBJECTIVE
  To assess the outcome of induced deliveries with IUGR.
  
  
  METHODS
  We reviewed the computerized files of parturients who underwent inducted labor because of IUGR (<5th percentile). Outcome assessment included mode of delivery, indication for CS, NICU admissions and 5 min Apgar score. We compared these parameters to a control group of women whose deliveries were induced for other indications.
  
  
  RESULTS
  A total of 836 women with IUGR were included. Mean gestational age and birth weight were 38.2 weeks and 2,114 g, respectively. Overall, 43% of women delivered by non-elective C/S. The rate of non-elective CS for other indications was 12.3% (P < 0.0001) for all deliveries and 23.6% (P < 0.001) for induced deliveries. CS was performed due to non-reassuring FHR in 63% of IUGR fetuses, compared with 27% of all induced deliveries. There were 160 women with IUGR who preferred elective CS. Their newborns' NICU admission and 5 min Apgar score <7 rates were lower than those for induced deliveries (NICU 43.1 and 29.4%, P < 0.05, 5 min Apgar <7 5 and 1%, P < 0.05).
  
  
  CONCLUSIONS
  Growth-restricted neonates born after labor induction had higher rates of low Apgar scores and NICU admissions compared to growth restricted neonates delivered by elective C/S. Inductions of labor for IUGR were associated with higher rates of non-elective C/S due to non-reassuring fetal heart rate compared with inductions performed for other indications.
authors.affiliation: Department of Obstetrics and Gynecology, Lis Maternity Hospital, Sourasky Medical Center, Tel Aviv, Israel. maslovitz@gmail.com
authors.forename: Sharon
authors.initials: S
authors.lastname: Maslovitz
authors.forename: Michael
authors.initials: M
authors.lastname: Shenhav
authors.forename: Ishai
authors.initials: I
authors.lastname: Levin
authors.forename: Benjamin
authors.initials: B
authors.lastname: Almog
authors.forename: Yifat
authors.initials: Y
authors.lastname: Ochshorn
authors.forename: Michael
authors.initials: M
authors.lastname: Kupferminc
authors.forename: Ariel
authors.initials: A
authors.lastname: Many
mesh_terms: D001034:Apgar Score; D001724:Birth Weight; D002585:Cesarean Section; D036861:Delivery, Obstetric / Q000379:methods*; D005260:Female; D005317:Fetal Growth Retardation; D005865:Gestational Age; D006340:Heart Rate, Fetal; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D015931:Intensive Care, Neonatal / Q000706:statistics & numerical data; D007751:Labor, Induced; D011247:Pregnancy; D011256:Pregnancy Outcome; D013997:Time Factors