Failed labor induction in nulliparous women at term: the role of pelvic floor muscle strength

Abstract

The prolongation, protraction or complete cessation of labor is called failed labor. It is one of the leading indications for cesarean delivery. The goal of this study was to measure pelvic floor muscle strength and investigate its effect on labor in nulliparous pregnant women. A total of 88 patients were included in the study. The study was conducted in nulliparous pregnant women with a low Bishop score (≤ 7). A low-dose intravenous oxytocin protocol was used for labor induction in all patients. Evaluation of pelvic floor muscle (PFM) strength was performed using a vaginal pressure measurement device just before labor induction. The duration of labor stages and the rate of failed labor were considered the main outcomes. The study group consisted of patients whose labor failed and who subsequently underwent cesarean delivery. The control group consisted of patients who delivered vaginally. The pelvic floor muscle strength and main outcome measures of the two groups were compared. No differences were found in age, weight, height, body mass index (BMI), and neonatal birth weight between the study and control groups. The mean resting and maximum squeeze pressures in the study group were 29.6 ± 9.8 and 56.4 ± 12.1 cm H(2)O respectively, significantly higher than in the control group. The best predictor of failed labor was a maximum squeeze pressure value of 59 cm H(2)0 (51.6% sensitivity and 87.7% specificity). Pelvic floor muscle strength appears to play a role in predicting failed labor.