Abstract
Induction of Labor in Obese Women -What Should We Know?
Highlights
Compared to women with normal weight, obese pregnant women have a higher rate of obstetric complications, namely hypertensive complications, gestational diabetes and fetal macrosomia [3,4]
In a study regarding prostaglandin induction of labor (IOL), failure of induction and the need of cesarean section (CS) occurred with 3.9% of obese class I and II women and 5.7% of women in class III obesity [4,5,6,7,8,9,10]
In another study this rate was 20.2% and 24.2%, respectively; women with a BMI 40-50kg/m2 had a failed induction rate of 31.6% and women with a BMI >60kg/m2 presented an IOL failure rate as high as 63.2% [11]. These facts reveal a gap in the knowledge about specific labor induction agents or methods more likely to result in vaginal delivery in obese patients [6]
Summary
Maternal obesity is becoming an epidemic in developed countries. This group of women presents an increased risk of labor induction due to the more prevalent associated obstetric comorbidities, such as gestational diabetes and hypertension. They have an increased rate of failed induction of labor (IOL), which relates directly with increasing body mass index. There are few studies comparing the efficacy of different cervical ripening’ agents in obese women and none prospective study titrating the dosage of oral misoprostol in induction of labor in those women. The purpose of this mini-review is to alert clinicians to the high failure rate of IOL in obese women and the best way to overcome this issue
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