The risk factors for failure of labor induction: a cohort study.
OBJECTIVE
To assess how some factors may influence the failure of labor induction.


METHODS
We conducted a prospective observational study from January 2009 to December 2011 with 248 patients who were admitted to the Obstetrics Unit of Ferrara University for labor induction. We selected only patients with unfavorable characteristics such as nulliparity, maternal and gestational age, and Bishop score and specific obstetric conditions such as mild preeclampsia, isolated oligohydramnios, premature rupture membrane, gestational diabetes, and hypertension for the success of labor induction.


RESULTS
The induction was carried out by rapid-release gel dinoprostone. 200 patients (80.6 %) delivered vaginally (Group A), while 48 (19.4 %) underwent a cesarean section (Group B). Maternal age was one independent significant variable (p = 0.01, OR 1.08) determining the risk of cesarean delivery. Patients affected by mild preeclampsia had a three times higher risk for cesarean section. Despite the several unfavorable characteristics of the patients, the cesarean section rate was comparable to that of the normal population.


CONCLUSIONS
Several factors and clinical conditions historically considered as negative predictors of induction result should be reassessed. The success of labor induction is determined by many maternal and fetal variables, which must all be taken into account to avoid unnecessary cesarean sections.
Department of Biomedical Sciences and Advanced Therapies, University of Ferrara, Corso Giovecca 183, 44121 Ferrara, Italy.
Emilio
E
Giugliano
Department of Biomedical Sciences and Advanced Therapies, University of Ferrara, Corso Giovecca 183, 44121 Ferrara, Italy.
Elisa
E
Cagnazzo
Department of Biomedical Sciences and Advanced Therapies, University of Ferrara, Corso Giovecca 183, 44121 Ferrara, Italy.
Viviana
V
Milillo
Department of Biomedical Sciences and Advanced Therapies, University of Ferrara, Corso Giovecca 183, 44121 Ferrara, Italy.
Massimo
M
Moscarini
Department of Biomedical Sciences and Advanced Therapies, University of Ferrara, Corso Giovecca 183, 44121 Ferrara, Italy.
Fortunato
F
Vesce
Department of Biomedical Sciences and Advanced Therapies, University of Ferrara, Corso Giovecca 183, 44121 Ferrara, Italy.
Donatella
D
Caserta
Department of Biomedical Sciences and Advanced Therapies, University of Ferrara, Corso Giovecca 183, 44121 Ferrara, Italy.
Roberto
R
Marci
Cesarean section; Dinoprostone; Labor induction; Vaginal PGE