Prognostic factors for successful induction of labor in intrauterine growth restriction after 36 weeks of gestation

Abstract

ObjectiveIn comparison to eutrophic fetuses, intra uterine growth restriction fetuses (IUGR) have a higher risk of perinatal morbi-mortality. There are no guidelines on the labor induction of labor (IOL) method to be performed in IUGR. The main objective was to determine fetal and maternal predictive factors of successful induction in IUGR fetuses from 36 weeks.Study designWe conducted a retrospective cohort single-center study including 320 women with a cephalic fetal presentation. Labour was induced after 36 weeks for suspected IUGR between January 2013 and December 2019. ResultsAmong the 320 patients, 246 were delivered vaginally (76.9 %) and 74 had a cesarean (23.1 %). Prognostic factors for successful IUGR induction were nonscarring uterus (OR 8.41; 95 %CI [2.92–24.21]), absence of preeclampsia (OR 7.14; 95 %CI [2.42–21.03]), multiparity (OR 4.32; 95 %CI [1.83–10.18]), normal fetal heart rate before IOL (OR 2.99; 95 %CI [1.24–7.22]) and BMI < 30 (OR 3.54; 95 %CI [1.62–7.72]). Doppler abnormalities, method and number of line of IOL, cervical evaluation were not significant in our study. ConclusionThe prognostic factors for successful IUGR induction are essentially maternal. Thus, a low BMI, multiparity, nonscarring uterus, absence of preeclampsia, and a normal FHR are good prognostic factors in IUGR induction.