title: Management of prolonged pregnancy by induction with a Foley catheter.
abstract: OBJECTIVE
  To describe labor outcomes in women with prolonged pregnancy and induction of labor with a Foley catheter, as compared with women with spontaneous onset of labor.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Helsinki University Hospital.
  
  
  METHODS
  553 women with uncomplicated prolonged pregnancies between January 2011 and January 2012, divided into 303 women (54.8%) with Foley catheter induction and 250 (45.2%) with spontaneous labor.
  
  
  METHODS
  Maternal and neonatal characteristics of women with uncomplicated singleton pregnancy of ≥41(+5) weeks of gestation were analyzed.
  
  
  METHODS
  Cesarean delivery rates, maternal and neonatal morbidity.
  
  
  RESULTS
  The cesarean delivery rate was 30.7% (n = 93/303) in women with labor induction and 4.8% (12/250) in women with spontaneous onset of labor (p < 0.001). The cesarean delivery rate was 37.3% (91/244) among nulliparous women with labor induction and 8.7% (11/126) among women with spontaneous labor, a sixfold increased risk (odds ratio 6.2). Among parous women, cesarean section rates were low and not significantly different (3.4% vs. 0.8%, p = 0.2). There were no differences in maternal intrapartum or postpartum infection rates or adverse neonatal outcomes between the groups.
  
  
  CONCLUSIONS
  Foley catheter induction of labor in prolonged pregnancy did not increase maternal or perinatal morbidity compared with spontaneous onset of labor but was associated with a considerably increased cesarean section rate, particularly among nulliparous women.
authors.affiliation: Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: Heidi
authors.initials: H
authors.lastname: Kruit
authors.affiliation: Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: Oskari
authors.initials: O
authors.lastname: Heikinheimo
authors.affiliation: Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: Veli-Matti
authors.initials: VM
authors.lastname: Ulander
authors.affiliation: Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: Ansa
authors.initials: A
authors.lastname: Aitokallio-Tallberg
authors.affiliation: Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: Irmeli
authors.initials: I
authors.lastname: Nupponen
authors.affiliation: Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: Jorma
authors.initials: J
authors.lastname: Paavonen
authors.affiliation: Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: Leena
authors.initials: L
authors.lastname: Rahkonen
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000706:statistics & numerical data; D005260:Female; D005387:Finland; D006801:Humans; D007231:Infant, Newborn; D007751:Labor, Induced / Q000295:instrumentation*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011273:Pregnancy, Prolonged / Q000628:therapy*; D012189:Retrospective Studies; D012307:Risk Factors; D014546:Urinary Catheterization
keywords: Foley catheter; Labor induction; cesarean delivery rate; nulliparous women; prolonged pregnancy