Outcomes of induction of labor after one prior cesarean

William A. Grobman; Sharon Gilbert; Mark B. Landon; Catherine Y. Spong; Kenneth J. Leveno; Dwight J. Rouse; Michael W. Varner; Atef H. Moawad; Steve N. Caritis; Margaret Harper; Ronald J. Wapner; Yoram Sorokin; Menachem Miodovnik; Marshall Carpenter; Mary J. O'Sullivan; Baha M. Sibai; Oded Langer; John M. Thorp; Susan M. Ramin; Brian M. Mercer

doi:10.1097/01.AOG.0000254169.49346.e9

Outcomes of induction of labor after one prior cesarean

William A. Grobman, Sharon Gilbert, Mark B. Landon, Catherine Y. Spong, Kenneth J. Leveno, Dwight J. Rouse, Michael W. Varner, Atef H. Moawad, Steve N. Caritis, Margaret Harper, Ronald J. Wapner, Yoram Sorokin, Menachem Miodovnik, Marshall Carpenter, Mary J. O'Sullivan, Baha M. Sibai, Oded Langer, John M. Thorp, Susan M. Ramin, Brian M. Mercer

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116 Scopus citations

Abstract

OBJECTIVE: To compare pregnancy outcomes in women with one prior low-transverse cesarean delivery after induction of labor with pregnancy outcomes after spontaneous labor. METHODS: This study is an analysis of women with one prior low-transverse cesarean and a singleton gestation who underwent a trial of labor and who were enrolled in a 4-year prospective observational study. Pregnancy outcomes were evaluated according to whether a woman underwent spontaneous labor or labor induction. RESULTS: Among the 11,778 women studied, vaginal delivery was less likely after induction of labor both in women without and with a prior vaginal delivery (51% versus 65%, P<.001; and 83% versus 88%, P<.001). An increased risk of uterine rupture after labor induction was found only in women with no prior vaginal delivery (1.5% versus 0.8%, P=.02; and 0.6% versus 0.4%, P=.42). Blood transfusion, venous thromboembolism, and hysterectomy were also more common with induction among women without a prior vaginal delivery. No measure of perinatal morbidity was associated with labor induction. An unfavorable cervix at labor induction was not associated with any adverse outcomes except an increased risk of cesarean delivery. CONCLUSION: Induction of labor in the study population is associated with an increased risk of cesarean delivery in all women with an unfavorable cervix, a statistically significant, albeit clinically small, increase in maternal morbidity in women with no prior vaginal delivery, and no appreciable increase in perinatal morbidity.

Original language	English (US)
Pages (from-to)	262-269
Number of pages	8
Journal	Obstetrics and gynecology
Volume	109
Issue number	2 PART 1
DOIs	https://doi.org/10.1097/01.AOG.0000254169.49346.e9
State	Published - Feb 2007

ASJC Scopus subject areas

Obstetrics and Gynecology

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10.1097/01.AOG.0000254169.49346.e9

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Grobman, W. A., Gilbert, S., Landon, M. B., Spong, C. Y., Leveno, K. J., Rouse, D. J., Varner, M. W., Moawad, A. H., Caritis, S. N., Harper, M., Wapner, R. J., Sorokin, Y., Miodovnik, M., Carpenter, M., O'Sullivan, M. J., Sibai, B. M., Langer, O., Thorp, J. M., Ramin, S. M., & Mercer, B. M. (2007). Outcomes of induction of labor after one prior cesarean. Obstetrics and gynecology, 109(2 PART 1), 262-269. https://doi.org/10.1097/01.AOG.0000254169.49346.e9

Grobman, WA, Gilbert, S, Landon, MB, Spong, CY, Leveno, KJ, Rouse, DJ, Varner, MW, Moawad, AH, Caritis, SN, Harper, M, Wapner, RJ, Sorokin, Y, Miodovnik, M, Carpenter, M, O'Sullivan, MJ, Sibai, BM, Langer, O, Thorp, JM, Ramin, SM & Mercer, BM 2007, 'Outcomes of induction of labor after one prior cesarean', Obstetrics and gynecology, vol. 109, no. 2 PART 1, pp. 262-269. https://doi.org/10.1097/01.AOG.0000254169.49346.e9

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title = "Outcomes of induction of labor after one prior cesarean",

abstract = "OBJECTIVE: To compare pregnancy outcomes in women with one prior low-transverse cesarean delivery after induction of labor with pregnancy outcomes after spontaneous labor. METHODS: This study is an analysis of women with one prior low-transverse cesarean and a singleton gestation who underwent a trial of labor and who were enrolled in a 4-year prospective observational study. Pregnancy outcomes were evaluated according to whether a woman underwent spontaneous labor or labor induction. RESULTS: Among the 11,778 women studied, vaginal delivery was less likely after induction of labor both in women without and with a prior vaginal delivery (51% versus 65%, P<.001; and 83% versus 88%, P<.001). An increased risk of uterine rupture after labor induction was found only in women with no prior vaginal delivery (1.5% versus 0.8%, P=.02; and 0.6% versus 0.4%, P=.42). Blood transfusion, venous thromboembolism, and hysterectomy were also more common with induction among women without a prior vaginal delivery. No measure of perinatal morbidity was associated with labor induction. An unfavorable cervix at labor induction was not associated with any adverse outcomes except an increased risk of cesarean delivery. CONCLUSION: Induction of labor in the study population is associated with an increased risk of cesarean delivery in all women with an unfavorable cervix, a statistically significant, albeit clinically small, increase in maternal morbidity in women with no prior vaginal delivery, and no appreciable increase in perinatal morbidity.",

author = "Grobman, {William A.} and Sharon Gilbert and Landon, {Mark B.} and Spong, {Catherine Y.} and Leveno, {Kenneth J.} and Rouse, {Dwight J.} and Varner, {Michael W.} and Moawad, {Atef H.} and Caritis, {Steve N.} and Margaret Harper and Wapner, {Ronald J.} and Yoram Sorokin and Menachem Miodovnik and Marshall Carpenter and O'Sullivan, {Mary J.} and Sibai, {Baha M.} and Oded Langer and Thorp, {John M.} and Ramin, {Susan M.} and Mercer, {Brian M.}",

year = "2007",

month = feb,

doi = "10.1097/01.AOG.0000254169.49346.e9",

language = "English (US)",

volume = "109",

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T1 - Outcomes of induction of labor after one prior cesarean

AU - Grobman, William A.

AU - Gilbert, Sharon

AU - Landon, Mark B.

AU - Spong, Catherine Y.

AU - Leveno, Kenneth J.

AU - Rouse, Dwight J.

AU - Varner, Michael W.

AU - Moawad, Atef H.

AU - Caritis, Steve N.

AU - Harper, Margaret

AU - Wapner, Ronald J.

AU - Sorokin, Yoram

AU - Miodovnik, Menachem

AU - Carpenter, Marshall

AU - O'Sullivan, Mary J.

AU - Sibai, Baha M.

AU - Langer, Oded

AU - Thorp, John M.

AU - Ramin, Susan M.

AU - Mercer, Brian M.

PY - 2007/2

Y1 - 2007/2

N2 - OBJECTIVE: To compare pregnancy outcomes in women with one prior low-transverse cesarean delivery after induction of labor with pregnancy outcomes after spontaneous labor. METHODS: This study is an analysis of women with one prior low-transverse cesarean and a singleton gestation who underwent a trial of labor and who were enrolled in a 4-year prospective observational study. Pregnancy outcomes were evaluated according to whether a woman underwent spontaneous labor or labor induction. RESULTS: Among the 11,778 women studied, vaginal delivery was less likely after induction of labor both in women without and with a prior vaginal delivery (51% versus 65%, P<.001; and 83% versus 88%, P<.001). An increased risk of uterine rupture after labor induction was found only in women with no prior vaginal delivery (1.5% versus 0.8%, P=.02; and 0.6% versus 0.4%, P=.42). Blood transfusion, venous thromboembolism, and hysterectomy were also more common with induction among women without a prior vaginal delivery. No measure of perinatal morbidity was associated with labor induction. An unfavorable cervix at labor induction was not associated with any adverse outcomes except an increased risk of cesarean delivery. CONCLUSION: Induction of labor in the study population is associated with an increased risk of cesarean delivery in all women with an unfavorable cervix, a statistically significant, albeit clinically small, increase in maternal morbidity in women with no prior vaginal delivery, and no appreciable increase in perinatal morbidity.

AB - OBJECTIVE: To compare pregnancy outcomes in women with one prior low-transverse cesarean delivery after induction of labor with pregnancy outcomes after spontaneous labor. METHODS: This study is an analysis of women with one prior low-transverse cesarean and a singleton gestation who underwent a trial of labor and who were enrolled in a 4-year prospective observational study. Pregnancy outcomes were evaluated according to whether a woman underwent spontaneous labor or labor induction. RESULTS: Among the 11,778 women studied, vaginal delivery was less likely after induction of labor both in women without and with a prior vaginal delivery (51% versus 65%, P<.001; and 83% versus 88%, P<.001). An increased risk of uterine rupture after labor induction was found only in women with no prior vaginal delivery (1.5% versus 0.8%, P=.02; and 0.6% versus 0.4%, P=.42). Blood transfusion, venous thromboembolism, and hysterectomy were also more common with induction among women without a prior vaginal delivery. No measure of perinatal morbidity was associated with labor induction. An unfavorable cervix at labor induction was not associated with any adverse outcomes except an increased risk of cesarean delivery. CONCLUSION: Induction of labor in the study population is associated with an increased risk of cesarean delivery in all women with an unfavorable cervix, a statistically significant, albeit clinically small, increase in maternal morbidity in women with no prior vaginal delivery, and no appreciable increase in perinatal morbidity.

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JO - Obstetrics and gynecology

JF - Obstetrics and gynecology

IS - 2 PART 1

ER -

Outcomes of induction of labor after one prior cesarean

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