The prognosis for spontaneous labor in women with uncomplicated term pregnancies: implications for cesarean delivery on maternal request.
OBJECTIVE
To assess the prognosis for vaginal delivery in women with entirely normal pregnancies who began spontaneous labor at term.


METHODS
Between January 1, 1988, and October 31, 2006, a total of 278,164 women delivered newborns at our hospital. A subset of women with uncomplicated pregnancies and spontaneous labor between 37 and 41 weeks of gestation then were identified for analysis of maternal and neonatal outcomes. The outcomes we studied included admission-to-delivery intervals, use of epidural analgesia, maternal perineal trauma, route of delivery, and several potential indices of neonatal condition at birth.


RESULTS
There were 103,526 (37%) women who delivered at our hospital during the study period who had normal term pregnancies and entered labor spontaneously. Overall, 96% of these women had vaginal deliveries, and adverse neonatal outcomes were rare. For example, perinatal deaths occurred in 0.3 of every 1,000 women.


CONCLUSIONS
Approximately one third of pregnant women have entirely normal pregnancies and enter spontaneous labor at term. Virtually all such women can anticipate safe vaginal deliveries for themselves and their infants.


METHODS
III.
Worley
Kevin C
KC
From the Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas.
McIntire
Donald D
DD
Leveno
Kenneth J
KJ
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D015360:Analgesia, Epidural / Q000706:statistics & numerical data; D016362:Analgesia, Obstetrical / Q000706:statistics & numerical data; D001034:Apgar Score; D001720:Birth Injuries / Q000453:epidemiology; D002585:Cesarean Section / Q000706:statistics & numerical data*; D004841:Episiotomy / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007743:Labor, Obstetric / Q000502:physiology*; D008297:Male; D009035:Mothers / Q000523:psychology*; D007744:Obstetric Labor Complications / Q000453:epidemiology* / Q000401:mortality; D054238:Perinatal Mortality; D011247:Pregnancy; D011256:Pregnancy Outcome; D011379:Prognosis; D047929:Term Birth; D055815:Young Adult