Predictors of cesarean delivery in women undergoing labor induction with a Foley balloon |
| |
Authors: | Shani Delaney Brian L Shaffer Yvonne W Cheng Juan Vargas Teresa N Sparks Kathleen Paul |
| |
Institution: | 1. Department of Obstetrics and Gynecology, University of Washington, Seattle, WA, USA,;2. Department of Obstetrics and Gynecology, Oregon Health &3. Science University, Portland, OR, USA, and;4. Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, CA, USA |
| |
Abstract: | Objective: To examine predictive characteristics for cesarean delivery (CD) in women undergoing labor induction with a Foley balloon (FB).Methods: A secondary analysis of a randomized, double-blind, control trial examining labor induction with a transcervical 30?mL or 60?mL FB. One-hundred ninety-nine women with term, vertex, singleton pregnancies and Bishop score 5 were randomized to receive a transcervical 30?mL or 60?mL FB. Mode of delivery, labor complications and neonatal outcomes were recorded. A multivariable model was performed to determine predictive characteristics for CD.Results: Increasing maternal age (p?=?0.04), nulliparity (p?=0.002) and chorioamnionitis (p?0.001) were significantly associated with an elevated risk for CD. Nulliparity was associated in an almost 4-fold increased CD risk (relative risk RR]: 3.88; 95% confidence interval CI]: 1.22–12.3). Women aged ≥?40 years, had an almost 3-fold increased risk of CD as compared to women aged 20–29 (RR: 2.91; 95% CI: 1.36–6.19) years. Chorioamnionitis was associated with nearly a 2-fold increased risk for CD (RR: 1.87; 95% CI: 1.06–3.32). A gestational age of ≥?41 weeks, prostaglandin use during induction and induction indication did not affect mode of delivery.Conclusion: In patients undergoing labor induction with a FB, increasing maternal age, nulliparity and chorioamnionitis are associated with an elevated risk for CD. |
| |
Keywords: | Bishop score cesarean delivery Foley catheter labor induction nulliparous |
|
|