Dose it reasonable to offer elective induction of labor to low-risk
nulliparous women after 39 weeks?A retrospective analysis.
Abstract
Objective To investigate the effect of induced labor on maternal and
fetal pregnancy outcome. Methods This is a retrospective case-control
study.In this study, a total of 4386 pregnant women with singleton
low-risk who underwent regular prenatal examination and successful
vaginal delivery at or more than 41 weeks 0 days of gestation in Fujian
Maternal and Child Health Hospital from January 2014 to December 2018.
Review the clinical data,according to the mode of labor initiation, they
were divided into induced labor group (2007 cases) and spontaneous onset
of labor group (2361 cases). Further stratified analysis was carried out
according to age and parity. Results The total duration of labor in the
induced labor group was significantly longer than that in the
spontaneous onset of labor group[ (9.37±5.37)vs (8.82±5.13)
h,P<0.001],associated with more postpartum blood loss[
(219.18±188.32)vs (199.95±124.69) mL,P=0.01], and the incidence of
severe postpartum hemorrhage(sPPH) was significantly
higher[0.8%(16/2007) vs 0.33% (8/2361),P =0.041];increase but no
significant difference in the incidence of postpartum hemorrhage(PPH)
[3.8 %(77/2007) vs 2.8% (66/2361),P =0.054]. After adjusting for
age, the operation of induced labor in nulliparous is more likely to
occur PPH[2.74 %(55/2007) vs 1.65
%(39/2361);OR=1.557;95%CI:1.039~2.332,P<0.05].
Conclusion Selective induction of labor increases the postpartum blood
loss,especially primary parturients to increase the risk of postpartum
hemorrhage, may be related to the prolongation of the total stage of
labor.Low-risk nulliparous women should try to avoid induction without
medical indication