Induction of labour for postdates in nulliparous women with uncomplicated pregnancy - is the caesarean section rate really lower?
Induction for "post-dates" is a very common procedure and in Queensland, Australia, accounts for 35.5% of all inductions. Systematic reviews all conclude that induction of labour does not increase the risk of caesarean section (CS). However, these reviews have generally included a mixed population and have not stratified for parity. We report in a retrospective cohort study involving only nulliparous women with uncomplicated singleton pregnancy at 40° to 416weeks that compared to spontaneous labour, incidence of CS was significantly higher in the induction group, 22.2% versus 12.1% (OR 2.06; 95% CI 1.93-2.20) at 40° to 416weeks versus spontaneous labour at 40° to 416weeks; and also higher at 21.0% versus 14.9% (OR 1.52; 95% CI 1.34-1.73) at 40° to 406weeks versus spontaneous labour at 41° to 416weeks (expectant management).
a Department of Obstetrics and Gynaecology , University of Queensland , Brisbane , QLD , Australia.|b Department of Obstetrics and Gynaecology , Ipswich Hospital , Ipswich , QLD , Australia.
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Mahomed
a Department of Obstetrics and Gynaecology , University of Queensland , Brisbane , QLD , Australia.
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Pungsornruk
c Mater Research Institute - The University of Queensland , South Brisbane , QLD , Australia.
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Gibbons
D000328:Adult; D001315:Australia / Q000453:epidemiology; D002585:Cesarean Section / Q000379:methods / Q000706:statistics & numerical data; D015331:Cohort Studies; D005260:Female; D005865:Gestational Age; D006801:Humans; D007751:Labor, Induced / Q000379:methods / Q000706:statistics & numerical data; D010298:Parity; D010346:Patient Care Management / Q000379:methods / Q000706:statistics & numerical data; D011247:Pregnancy; D011273:Pregnancy, Prolonged / Q000453:epidemiology / Q000628:therapy; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors
Caesarean section; labour induction; nulliparity