title: Outcomes of induced versus spontaneous labor.
abstract: OBJECTIVE
  Induced labor is associated with a higher request for analgesia than spontaneous labor. This study compared duration of labor, mode of delivery, quantity of blood loss, type of perineal outcome and neonatal outcomes between women in induced labor and women in spontaneous labor, both on epidural analgesia (administered at cervical dilation  ≤ 4 cm).
  
  
  METHODS
  In a two-year longitudinal cohort study, data were gathered from nulliparous women with a single cephalic pregnancy of at least 37 weeks attending the labor and delivery ward in Policlinico San Matteo Fundation-Pavia. Data were compared for women with early labor analgesia in (1) spontaneous labor (Robson group 1) and (2) induced labor (dinoprostone - vaginal insert or gel, Robson group 2a).
  
  
  RESULTS
  Of the 1104 women who underwent epidural analgesia in the study period, 531 were included: 326 in spontaneous labor and 205 in induced labor. The only significant difference found was duration of the first stage, which lasted 305 (200-390) min in spontaneous labor compared to 205 min (120-345) in induced labor (p  <0.001).
  
  
  CONCLUSIONS
  In women on early epidural analgesia, induction is associated with a shorter duration of the first stage of labor and does not affect other outcomes.
authors.affiliation: a Department of Anesthesia and Intensive care - Unit of Obstetric Anesthesia.
authors.forename: Silvia
authors.initials: S
authors.lastname: Poma
authors.affiliation: b Clinical Epidemiology and Biostatistics, Scientific Direction , and.
authors.forename: Luigia
authors.initials: L
authors.lastname: Scudeller
authors.affiliation: c Department of Obstetrics and Gynecology , IRCCS Policlinic San Matteo Hospital Foundation , Pavia , Italy.
authors.forename: Barbara
authors.initials: B
authors.lastname: Gardella
authors.affiliation: a Department of Anesthesia and Intensive care - Unit of Obstetric Anesthesia.
authors.forename: Federica
authors.initials: F
authors.lastname: Broglia
authors.affiliation: a Department of Anesthesia and Intensive care - Unit of Obstetric Anesthesia.
authors.forename: Maria
authors.initials: M
authors.lastname: Ciceri
authors.affiliation: a Department of Anesthesia and Intensive care - Unit of Obstetric Anesthesia.
authors.forename: Marinella
authors.initials: M
authors.lastname: Fuardo
authors.affiliation: a Department of Anesthesia and Intensive care - Unit of Obstetric Anesthesia.
authors.forename: Simona
authors.initials: S
authors.lastname: Pellicori
authors.affiliation: a Department of Anesthesia and Intensive care - Unit of Obstetric Anesthesia.
authors.forename: Filippo
authors.initials: F
authors.lastname: Repossi
authors.affiliation: a Department of Anesthesia and Intensive care - Unit of Obstetric Anesthesia.
authors.forename: Silvia
authors.initials: S
authors.lastname: Zizzi
authors.affiliation: a Department of Anesthesia and Intensive care - Unit of Obstetric Anesthesia.
authors.forename: Silvano
authors.initials: S
authors.lastname: Noli
authors.affiliation: a Department of Anesthesia and Intensive care - Unit of Obstetric Anesthesia.
authors.forename: Maria Paola
authors.initials: MP
authors.lastname: Delmonte
authors.affiliation: a Department of Anesthesia and Intensive care - Unit of Obstetric Anesthesia.
authors.forename: Giorgio Antonio
authors.initials: GA
authors.lastname: Iotti
mesh_terms: D000328:Adult; D015360:Analgesia, Epidural; D016362:Analgesia, Obstetrical; D036861:Delivery, Obstetric / Q000706:statistics & numerical data; D015232:Dinoprostone / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007747:Labor Stage, First / Q000187:drug effects / Q000502:physiology*; D007751:Labor, Induced / Q000706:statistics & numerical data*; D008137:Longitudinal Studies; D010120:Oxytocics / Q000627:therapeutic use; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies; D013997:Time Factors; D055815:Young Adult
chemical_list: D010120:Oxytocics; D015232:Dinoprostone
keywords: Duration of labor; epidural analgesia; induced labor; prostaglandins