Induction Method Combination in Patients With Hypertensive Disorders of Pregnancy [ID 2683632

Abstract

INTRODUCTION: We aim to evaluate cesarean birth (CB) rates according to induction method combinations in patients with hypertensive disorders of pregnancy (HDP). METHODS: We conducted a retrospective study including singleton pregnancies with HDP admitted to labor and delivery at a tertiary center from January 2018 to December 2019. Clinical and sociodemographic data were extracted from electronic medical records. Pregnancies with incomplete data and those who declined a trial of labor were excluded. Hypertensive disorder of pregnancy was defined according to the American College of Obstetricians and Gynecologists classification. Cesarean birth rates were compared among induction agent combinations using binary logistic regression. A value of P<.05 was considered significant. RESULTS: A total of 552 pregnancies met inclusion criteria. Of these, 113 were induced with oxytocin, 112 with mechanical agents and oxytocin, 58 with a mechanical method and prostaglandins, 31 received prostaglandins alone, 54 received oxytocin and prostaglandins, 80 received oxytocin, prostaglandins, and a mechanical agent, 35 were induced with mechanical methods, and 69 were in spontaneous labor. Demographic and baseline characteristics were not different by induction agent combination. After logistic regression, the combination of prostaglandins and mechanical agents was associated with a decreased CB rate; odds ratio, 0.4 (95% CI: 0.1–0.9), using those in spontaneous labor as reference. No other agent combination was associated with an increased or decreased in CB rate. CONCLUSION: Induction of labor with a combination of prostaglandins and mechanical agents may decrease CB rates compared with other combination methods for induction in pregnancies with HDP.