title: Duration of Oxytocin and Rupture of the Membranes Before Diagnosing a Failed Induction of Labor.
abstract: To compare maternal and neonatal outcomes based on length of the latent phase during induction with rupture of membranes before 6 cm dilation.
  
  
  
  This is a retrospective cohort study using data from the Consortium of Safe Labor study, including 9,763 nulliparous and 8,379 multiparous women with singleton, term pregnancies undergoing induction at 2 cm dilation or less with rupture of membranes before 6 cm dilation after which the latent phase ended. Outcomes were evaluated according to duration of oxytocin and rupture of membranes.
  
  
  
  At time points from 6 to 18 hours of oxytocin and rupture of membranes, the rates of nulliparous women remaining in the latent phase declined (35.9-1.4%) and the rates of vaginal delivery for those remaining in the latent phase at these time periods decreased (54.1-29.9%) Nulliparous women remaining in the latent phase for 12 hours compared with women who had exited the latent phase had significantly increased rates of chorioamnionitis (12.1% compared with 4.1%) and endometritis (3.6% compared with 1.3%) and increased rates of neonatal intensive care unit admission (8.7% compared with 6.3%). Similar patterns were present for multiparous women at 15 hours.
  
  
  
  Based on when neonatal morbidity increased, in an otherwise uncomplicated induction of labor with rupture of membranes, a latent phase after initiation of oxytocin of at least 12 hours for nulliparous women and 15 hours in multiparous women is a reasonable criterion for diagnosing a failed induction.
authors.affiliation: Departments of Obstetrics and Gynecology, MedStar Washington Hospital Center and MedStar Georgetown University Hospital, and the Georgetown-Howard Universities Center for Clinical and Translational Science, Washington, DC; the Department of Biostatistics and Bioinformatics, MedStar Health Research Institute, Hyattsville, Maryland; and the Department of Maternal Fetal Medicine, Christiana Care Health System, Newark, Delaware.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Kawakita
authors.forename: Uma M
authors.initials: UM
authors.lastname: Reddy
authors.forename: Sara N
authors.initials: SN
authors.lastname: Iqbal
authors.forename: Helain J
authors.initials: HJ
authors.lastname: Landy
authors.forename: Chun-Chih
authors.initials: CC
authors.lastname: Huang
authors.forename: Matthew
authors.initials: M
authors.lastname: Hoffman
authors.forename: Anthony C
authors.initials: AC
authors.lastname: Sciscione
authors.forename: Katherine L
authors.initials: KL
authors.lastname: Grantz
mesh_terms: D000328:Adult; D002821:Chorioamnionitis / Q000453:epidemiology; D004716:Endometritis / Q000453:epidemiology; D005321:Extraembryonic Membranes; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D015931:Intensive Care, Neonatal / Q000706:statistics & numerical data; D007751:Labor, Induced; D007743:Labor, Obstetric / Q000187:drug effects; D010120:Oxytocics / Q000008:administration & dosage*; D010121:Oxytocin / Q000008:administration & dosage*; D010298:Parity; D011247:Pregnancy; D012189:Retrospective Studies; D013997:Time Factors; D017211:Treatment Failure; D055815:Young Adult
chemical_list: D010120:Oxytocics; D010121:Oxytocin