Failed labor induction: toward an objective diagnosis.

Hdl Handle:
http://hdl.handle.net/10147/144296
Title:
Failed labor induction: toward an objective diagnosis.
Authors:
Rouse, Dwight J; Weiner, Steven J; Bloom, Steven L; Varner, Michael W; Spong, Catherine Y; Ramin, Susan M; Caritis, Steve N; Grobman, William A; Sorokin, Yoram; Sciscione, Anthony; Carpenter, Marshall W; Mercer, Brian M; Thorp, John M; Malone, Fergal D; Harper, Margaret; Iams, Jay D; Anderson, Garland D
Affiliation:
Brown University, Warren Alpert Medical School, Department of Obstetrics and Gynecology, Providence, RI 02905, USA. drouse@wihri.org
Citation:
Failed labor induction: toward an objective diagnosis. 2011, 117 (2 Pt 1):267-72 Obstet Gynecol
Journal:
Obstetrics and gynecology
Issue Date:
Feb-2011
URI:
http://hdl.handle.net/10147/144296
DOI:
10.1097/AOG.0b013e318207887a
PubMed ID:
21252738
Abstract:
To evaluate maternal and perinatal outcomes in women undergoing labor induction with an unfavorable cervix according to duration of oxytocin administration in the latent phase of labor after ruptured membranes.; This was a secondary analysis of a randomized multicenter trial in which all cervical examinations from admission were recorded. Inclusion criteria: nulliparas at or beyond 36 weeks of gestation undergoing induction with a cervix of 2 cm or less dilated and less than completely effaced. The latent phase of labor was defined as ending at a cervical dilation of 4 cm and effacement of at least 90%, or at a cervical dilation of 5 cm regardless of effacement.; A total of 1,347 women were analyzed. The overall vaginal delivery rate was 63.2%. Most women had exited the latent phase after 6 hours of oxytocin and membrane rupture (n=939; 69.7%); only 5% remained in the latent phase after 12 hours. The longer the latent phase, the lower the vaginal delivery rate. Even so, 39.4% of the 71 women who remained in the latent phase after 12 hours of oxytocin and membrane rupture were delivered vaginally. Chorioamnionitis, endometritis, or both, and uterine atony were the only maternal adverse outcomes related to latent-phase duration: adjusted odds ratios (95% confidence intervals) of 1.12 (1.07, 1.17) and 1.13 (1.06, 1.19), respectively, for each additional hour. Neonatal outcomes were not related to latent-phase duration.; Almost 40% of the women who remained in the latent phase after 12 hours of oxytocin and membrane rupture were delivered vaginally. Therefore, it is reasonable to avoid deeming labor induction a failure in the latent phase until oxytocin has been administered for at least 12 hours after membrane rupture.; III.
Item Type:
Article
Language:
en
Description:
OBJECTIVE: To evaluate maternal and perinatal outcomes in women undergoing labor induction with an unfavorable cervix according to duration of oxytocin administration in the latent phase of labor after ruptured membranes. METHODS: This was a secondary analysis of a randomized multicenter trial in which all cervical examinations from admission were recorded. Inclusion criteria: nulliparas at or beyond 36 weeks of gestation undergoing induction with a cervix of 2 cm or less dilated and less than completely effaced. The latent phase of labor was defined as ending at a cervical dilation of 4 cm and effacement of at least 90%, or at a cervical dilation of 5 cm regardless of effacement. RESULTS: A total of 1,347 women were analyzed. The overall vaginal delivery rate was 63.2%. Most women had exited the latent phase after 6 hours of oxytocin and membrane rupture (n=939; 69.7%); only 5% remained in the latent phase after 12 hours. The longer the latent phase, the lower the vaginal delivery rate. Even so, 39.4% of the 71 women who remained in the latent phase after 12 hours of oxytocin and membrane rupture were delivered vaginally. Chorioamnionitis, endometritis, or both, and uterine atony were the only maternal adverse outcomes related to latent-phase duration: adjusted odds ratios (95% confidence intervals) of 1.12 (1.07, 1.17) and 1.13 (1.06, 1.19), respectively, for each additional hour. Neonatal outcomes were not related to latent-phase duration. CONCLUSION: Almost 40% of the women who remained in the latent phase after 12 hours of oxytocin and membrane rupture were delivered vaginally. Therefore, it is reasonable to avoid deeming labor induction a failure in the latent phase until oxytocin has been administered for at least 12 hours after membrane rupture.
ISSN:
1873-233X

Full metadata record

DC FieldValue Language
dc.contributor.authorRouse, Dwight Jen
dc.contributor.authorWeiner, Steven Jen
dc.contributor.authorBloom, Steven Len
dc.contributor.authorVarner, Michael Wen
dc.contributor.authorSpong, Catherine Yen
dc.contributor.authorRamin, Susan Men
dc.contributor.authorCaritis, Steve Nen
dc.contributor.authorGrobman, William Aen
dc.contributor.authorSorokin, Yoramen
dc.contributor.authorSciscione, Anthonyen
dc.contributor.authorCarpenter, Marshall Wen
dc.contributor.authorMercer, Brian Men
dc.contributor.authorThorp, John Men
dc.contributor.authorMalone, Fergal Den
dc.contributor.authorHarper, Margareten
dc.contributor.authorIams, Jay Den
dc.contributor.authorAnderson, Garland Den
dc.date.accessioned2011-10-07T14:01:41Z-
dc.date.available2011-10-07T14:01:41Z-
dc.date.issued2011-02-
dc.identifier.citationFailed labor induction: toward an objective diagnosis. 2011, 117 (2 Pt 1):267-72 Obstet Gynecolen
dc.identifier.issn1873-233X-
dc.identifier.pmid21252738-
dc.identifier.doi10.1097/AOG.0b013e318207887a-
dc.identifier.urihttp://hdl.handle.net/10147/144296-
dc.descriptionOBJECTIVE: To evaluate maternal and perinatal outcomes in women undergoing labor induction with an unfavorable cervix according to duration of oxytocin administration in the latent phase of labor after ruptured membranes. METHODS: This was a secondary analysis of a randomized multicenter trial in which all cervical examinations from admission were recorded. Inclusion criteria: nulliparas at or beyond 36 weeks of gestation undergoing induction with a cervix of 2 cm or less dilated and less than completely effaced. The latent phase of labor was defined as ending at a cervical dilation of 4 cm and effacement of at least 90%, or at a cervical dilation of 5 cm regardless of effacement. RESULTS: A total of 1,347 women were analyzed. The overall vaginal delivery rate was 63.2%. Most women had exited the latent phase after 6 hours of oxytocin and membrane rupture (n=939; 69.7%); only 5% remained in the latent phase after 12 hours. The longer the latent phase, the lower the vaginal delivery rate. Even so, 39.4% of the 71 women who remained in the latent phase after 12 hours of oxytocin and membrane rupture were delivered vaginally. Chorioamnionitis, endometritis, or both, and uterine atony were the only maternal adverse outcomes related to latent-phase duration: adjusted odds ratios (95% confidence intervals) of 1.12 (1.07, 1.17) and 1.13 (1.06, 1.19), respectively, for each additional hour. Neonatal outcomes were not related to latent-phase duration. CONCLUSION: Almost 40% of the women who remained in the latent phase after 12 hours of oxytocin and membrane rupture were delivered vaginally. Therefore, it is reasonable to avoid deeming labor induction a failure in the latent phase until oxytocin has been administered for at least 12 hours after membrane rupture.en
dc.description.abstractTo evaluate maternal and perinatal outcomes in women undergoing labor induction with an unfavorable cervix according to duration of oxytocin administration in the latent phase of labor after ruptured membranes.-
dc.description.abstractThis was a secondary analysis of a randomized multicenter trial in which all cervical examinations from admission were recorded. Inclusion criteria: nulliparas at or beyond 36 weeks of gestation undergoing induction with a cervix of 2 cm or less dilated and less than completely effaced. The latent phase of labor was defined as ending at a cervical dilation of 4 cm and effacement of at least 90%, or at a cervical dilation of 5 cm regardless of effacement.-
dc.description.abstractA total of 1,347 women were analyzed. The overall vaginal delivery rate was 63.2%. Most women had exited the latent phase after 6 hours of oxytocin and membrane rupture (n=939; 69.7%); only 5% remained in the latent phase after 12 hours. The longer the latent phase, the lower the vaginal delivery rate. Even so, 39.4% of the 71 women who remained in the latent phase after 12 hours of oxytocin and membrane rupture were delivered vaginally. Chorioamnionitis, endometritis, or both, and uterine atony were the only maternal adverse outcomes related to latent-phase duration: adjusted odds ratios (95% confidence intervals) of 1.12 (1.07, 1.17) and 1.13 (1.06, 1.19), respectively, for each additional hour. Neonatal outcomes were not related to latent-phase duration.-
dc.description.abstractAlmost 40% of the women who remained in the latent phase after 12 hours of oxytocin and membrane rupture were delivered vaginally. Therefore, it is reasonable to avoid deeming labor induction a failure in the latent phase until oxytocin has been administered for at least 12 hours after membrane rupture.-
dc.description.abstractIII.-
dc.language.isoenen
dc.titleFailed labor induction: toward an objective diagnosis.en
dc.typeArticleen
dc.contributor.departmentBrown University, Warren Alpert Medical School, Department of Obstetrics and Gynecology, Providence, RI 02905, USA. drouse@wihri.orgen
dc.identifier.journalObstetrics and gynecologyen
dc.description.provinceLeinster-

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