Abstract
Background: Maternal obesity is reported to be associated with increased incidence of gestational diabetes mellitus and hypertension. These cause failure of labour induction, leading to higher incidence of cesarean section (CS). The aim of this study was to assess which reduces CS rate, labor induction at 39 weeks or leaving women for spontaneous labor onset till 41 weeks. Methodology: A randomized controlled trial was conducted in Ain Shams Maternity Hospital in Egypt from 2016 to 2018. Study population consisted of 200 term primigravida pregnant obese women delivered in Ain Shams Maternity Hospital. They were divided into two groups: Group A: induction of labor at 39 + 0 weeks (n = 100) by vaginal administration of 25 μg misoprostol (PGE1) every 6 hours for 5 doses; Group B: waiting spontaneous labor onset till 41 + 0 weeks (n = 100), and if no spontaneous labor occurred at 41 weeks, induction was performed in the same way. Results: Induction (Group A) vs. waiting spontaneous labor (Group B) showed the followings, which were significant: CS: 22% vs 39%, p = 0.009; maternal birth injury: 4% vs 12%, p = 0.037; non-assisted vaginal deliveries: 93.6% vs 78.7%, p = 0.034; APGAR scores at 1 & 5 min: 7.6 ± 0.8 vs 7.3 ± 1.1 p = 0.038, 8.4 ± 1.0 vs 8.1 ± 1.3 p = 0.040, respectively; birth weight; 3.3 ± 0.1 vs 3.5 ± 0.2 kg, p Conclusion: CS rate was significantly lower in women with induction of labor at 39 weeks than those waiting for spontaneous labor onset till 41 weeks in obese Egyptian pregnant women.
Highlights
Obesity is clinically defined as is a medical condition in which accumulation of excess body fat to an extent may have a negative effect on health
They were divided into two groups: Group A: induction of labor at 39 + 0 weeks (n = 100) by vaginal administration of 25 μg misoprostol (PGE1) every 6 hours for 5 doses; Group B: waiting spontaneous labor onset till 41 + 0 weeks (n = 100), and if no spontaneous labor occurred at 41 weeks, induction was performed in the same way
cesarean section (CS) rate was significantly lower in women with induction of labor at 39 weeks than those waiting for spontaneous labor onset till 41 weeks in obese Egyptian pregnant women
Summary
Obesity is clinically defined as is a medical condition in which accumulation of excess body fat to an extent may have a negative effect on health. Maternal obesity is reported to be associated with increased incidence of gestational diabetes mellitus and hypertension These cause failure of labour induction, leading to higher incidence of cesarean section (CS). Study population consisted of 200 term primigravida pregnant obese women delivered in Ain Shams Maternity Hospital. They were divided into two groups: Group A: induction of labor at 39 + 0 weeks (n = 100) by vaginal administration of 25 μg misoprostol (PGE1) every 6 hours for 5 doses; Group B: waiting spontaneous labor onset till 41 + 0 weeks (n = 100), and if no spontaneous labor occurred at 41 weeks, induction was performed in the same way. Conclusion: CS rate was significantly lower in women with induction of labor at 39 weeks than those waiting for spontaneous labor onset till 41 weeks in obese Egyptian pregnant women
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