Abstract
Induction of labor (IL) is a common obstetric procedure, but it is questionable whether or not it results in higher cesarean section (CS) rates. The present study aims to evaluate the impact of IL in the overall CS rates and to analyze these rates according to the method of IL employed and to the Robson group in which it was applied. We have conducted a retrospective study including pregnant women whose labor was induced at a tertiary hospital in 2015 and 2016. All women were classified according to the Robson Classification System (RCS). The CS rates were analyzed and compared regarding the method of IL employed. A total of 1,166 cases were included. The CS rate after IL was 20.9%, which represented 23.1% of the total of CSs performed in 2015 and 2016. The highest CS rates were recorded in RCS groups 5 (65.2%) and 8 (32.3%). Group 2 was the highest contributor to the overall CS rate, since it represented 56.7% of the population. The intravaginal prostaglandins method was the most used (77%). Transcervical Foley catheter was the preferred method in group 5 and intravaginal prostaglandins in all the other groups. The CS rate was higher when transcervical Foley catheter was used (34.1%). Transcervical Foley catheter induction was associated with a higher rate of CS, probably because it was the preferred method used in group 5.
Highlights
MethodsInduction of labor (IL) is a common obstetric procedure, and the number of cases in which labor is induced seems to have been rising in the last decades.[1]
We have aimed to evaluate the impact of IL in the overall cesarean section (CS) rate, as well as to analyze CS rates according to the method of IL employed and to the Robson group in which it was applied
The transcervical Foley catheter was the preferred method in group 5 (74.2%), while the intravaginal prostaglandins method was the most used in all other groups (79.6–100%)
Summary
MethodsInduction of labor (IL) is a common obstetric procedure, and the number of cases in which labor is induced seems to have been rising in the last decades.[1]. The choice between multiple methods for IL, from mechanic to pharmacological, should be based on the clinical situation and the available resources. Since it is not a risk-free procedure, it should not be performed without a formal and reasoned medical indication.[5]. More recent studies described a reduction in CS rates after IL in term pregnancies, without an increment on perinatal morbidity.[6,7,8] there are significant differences between the considered populations and the applied methodologies, making the results of those studies inconsistent and controversial.[4,6,7,8,9]
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