Predicting the Antepartum Factors Resulted in Failed Labor Induction in Nulliparous Term Pregnancies

Abstract

Objectives: This study aimed to evaluate the feasibility of using a computerized machine to predict a successful normal vaginal delivery and determine the antepartum factors involved in failed labor induction in nulliparous term women. Methods: This prospective cohort study was conducted in Yas Hospital affiliated with Tehran University of Medical Sciences from 2017 to 2019. The data used for the computerized system were obtained during the admission of the term nulliparous women with singleton pregnancy in cephalic presentation. The cesarean delivery rate, as well as maternal and perinatal outcomes, were evaluated. The input variables were maternal age, gravida, gestational age at birth, necessity and type of labor induction, presentation of the baby at birth, Bishop Score, fetal weight, and fetal head circumference, and maternal disorders. The outputs were vaginal deliveries or cesarean sections. Results: The rate of cesarean section was 41.8% (n = 287). Higher maternal age (OR = 1.044, P = 0.018, CI = 1.007 - 1.082), lower Bishop Score (OR = 0.192, P < 0.001, CI = 0.139 - 0.256) and non-occiput anterior position (OR = 82.194, P < 0.001, CI = 15.888 - 425.214) were significantly associated with failed induction. Conclusions: The result of this study may be beneficial for healthcare providers to predict the delivery route, the risk of labor induction failure and make a personal decision according to each individual.