Predictors of response after a second attempt of pharmacological labor induction: a retrospective study
Purpose The aim of our study was to assess the outcomes of a prolonged induction carried out with a second sequential cycle of pharmacological stimulation after unsatisfactory response to a first attempt, and to highlight variables correlated with higher response rates. Methods A retrospective study...
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| Veröffentlicht in: | Archives of gynecology and obstetrics 2020-07, Vol.302 (1), p.117-125 |
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| creator | Mariani, Luca Liban Mancarella, Matteo Fuso, Luca Novara, Lorenzo Menato, Guido Biglia, Nicoletta |
| description | Purpose
The aim of our study was to assess the outcomes of a prolonged induction carried out with a second sequential cycle of pharmacological stimulation after unsatisfactory response to a first attempt, and to highlight variables correlated with higher response rates.
Methods
A retrospective study was carried out on 157 women who underwent a two-step labor induction by vaginal prostaglandins followed by a second cycle of prostaglandins or intravenous oxytocin. Outcomes assessed were mode of delivery and maternal and neonatal morbidity. Main variables of pregnancy and delivery were collected to identify factors predicting the mode of delivery.
Results
Among 157 patients, 63 (40.1%) achieved a vaginal delivery, whereas 94 (59.9%) underwent Cesarean section, 9 women (5.7%) had postpartum hemorrhage; in 2 cases (1.3%), an Apgar score |
| doi_str_mv | 10.1007/s00404-020-05578-3 |
| format | Article |
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The aim of our study was to assess the outcomes of a prolonged induction carried out with a second sequential cycle of pharmacological stimulation after unsatisfactory response to a first attempt, and to highlight variables correlated with higher response rates.
Methods
A retrospective study was carried out on 157 women who underwent a two-step labor induction by vaginal prostaglandins followed by a second cycle of prostaglandins or intravenous oxytocin. Outcomes assessed were mode of delivery and maternal and neonatal morbidity. Main variables of pregnancy and delivery were collected to identify factors predicting the mode of delivery.
Results
Among 157 patients, 63 (40.1%) achieved a vaginal delivery, whereas 94 (59.9%) underwent Cesarean section, 9 women (5.7%) had postpartum hemorrhage; in 2 cases (1.3%), an Apgar score < 7 at 5 min from birth was reported. Higher risk of Cesarean section was observed with advanced maternal age (OR 1.13 for additional year, CI 1.04–1.22) and nulliparity (OR 8.84, CI 2.69–29.06), whereas the response rates were better in carriers of group B streptococcus colonization (OR 0.38, CI 0.17–0.84) and in women with favorable cervical status after the first stimulation (OR 0.81 for additional point of Bishop score, CI 0.70–0.94).
Conclusion
Labor induction with two cycles of pharmacological stimulation is a procedure with fairly good success rates and a low risk of maternal and neonatal complications. Factors predicting its success encompass younger age, parity, a positive recto-vaginal swab for group B streptococcus and a favorable cervix following the first cycle of stimulation.</description><identifier>ISSN: 0932-0067</identifier><identifier>EISSN: 1432-0711</identifier><identifier>DOI: 10.1007/s00404-020-05578-3</identifier><identifier>PMID: 32445065</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Apgar score ; Cesarean section ; Childbirth & labor ; Endocrinology ; Gynecology ; Health risk assessment ; Human Genetics ; Induced labor ; Maternal-Fetal Medicine ; Medicine ; Medicine & Public Health ; Obstetrics/Perinatology/Midwifery ; Response rates ; Vagina</subject><ispartof>Archives of gynecology and obstetrics, 2020-07, Vol.302 (1), p.117-125</ispartof><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2020</rights><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2020.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-60e1665a957c806822a25e0247f8cedd5eff13ccd0b71740e7a98dbef25dfac83</citedby><cites>FETCH-LOGICAL-c375t-60e1665a957c806822a25e0247f8cedd5eff13ccd0b71740e7a98dbef25dfac83</cites><orcidid>0000-0003-1009-5309</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00404-020-05578-3$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00404-020-05578-3$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32445065$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mariani, Luca Liban</creatorcontrib><creatorcontrib>Mancarella, Matteo</creatorcontrib><creatorcontrib>Fuso, Luca</creatorcontrib><creatorcontrib>Novara, Lorenzo</creatorcontrib><creatorcontrib>Menato, Guido</creatorcontrib><creatorcontrib>Biglia, Nicoletta</creatorcontrib><title>Predictors of response after a second attempt of pharmacological labor induction: a retrospective study</title><title>Archives of gynecology and obstetrics</title><addtitle>Arch Gynecol Obstet</addtitle><addtitle>Arch Gynecol Obstet</addtitle><description>Purpose
The aim of our study was to assess the outcomes of a prolonged induction carried out with a second sequential cycle of pharmacological stimulation after unsatisfactory response to a first attempt, and to highlight variables correlated with higher response rates.
Methods
A retrospective study was carried out on 157 women who underwent a two-step labor induction by vaginal prostaglandins followed by a second cycle of prostaglandins or intravenous oxytocin. Outcomes assessed were mode of delivery and maternal and neonatal morbidity. Main variables of pregnancy and delivery were collected to identify factors predicting the mode of delivery.
Results
Among 157 patients, 63 (40.1%) achieved a vaginal delivery, whereas 94 (59.9%) underwent Cesarean section, 9 women (5.7%) had postpartum hemorrhage; in 2 cases (1.3%), an Apgar score < 7 at 5 min from birth was reported. Higher risk of Cesarean section was observed with advanced maternal age (OR 1.13 for additional year, CI 1.04–1.22) and nulliparity (OR 8.84, CI 2.69–29.06), whereas the response rates were better in carriers of group B streptococcus colonization (OR 0.38, CI 0.17–0.84) and in women with favorable cervical status after the first stimulation (OR 0.81 for additional point of Bishop score, CI 0.70–0.94).
Conclusion
Labor induction with two cycles of pharmacological stimulation is a procedure with fairly good success rates and a low risk of maternal and neonatal complications. Factors predicting its success encompass younger age, parity, a positive recto-vaginal swab for group B streptococcus and a favorable cervix following the first cycle of stimulation.</description><subject>Apgar score</subject><subject>Cesarean section</subject><subject>Childbirth & labor</subject><subject>Endocrinology</subject><subject>Gynecology</subject><subject>Health risk assessment</subject><subject>Human Genetics</subject><subject>Induced labor</subject><subject>Maternal-Fetal Medicine</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Obstetrics/Perinatology/Midwifery</subject><subject>Response rates</subject><subject>Vagina</subject><issn>0932-0067</issn><issn>1432-0711</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kUtv1TAQhS1ERS-FP8ACWWLDJjB-J-xQxUuqRBdlbfna40uqJA62g9R_X19uAYkFK4_s75wZzyHkBYM3DMC8LQASZAccOlDK9J14RHZMCt6BYewx2cFwrEGbc_K0lFsAxvtePyHngkupQKsdOVxnDKOvKReaIs1Y1rQUpC5WzNTRgj4tgbpacV7rEVm_uzw7n6Z0GL2b6OT2KdNxCZuvY1reNVHGmlNZsV38RFrqFu6ekbPopoLPH84L8u3jh5vLz93V109fLt9fdV4YVTsNyLRWblDG96B7zh1XCFya2HsMQWGMTHgfYG-YkYDGDX3YY-QqROd7cUFen3zXnH5sWKqdx-JxmtyCaSuWS9ACpB6goa_-QW_Tlpc23ZHqjeDDoBvFT5RvXyoZo13zOLt8ZxnYYwz2FINtMdhfMVjRRC8frLf9jOGP5PfeGyBOQGlPywHz397_sb0HhLaT4w</recordid><startdate>20200701</startdate><enddate>20200701</enddate><creator>Mariani, Luca Liban</creator><creator>Mancarella, Matteo</creator><creator>Fuso, Luca</creator><creator>Novara, Lorenzo</creator><creator>Menato, Guido</creator><creator>Biglia, Nicoletta</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-1009-5309</orcidid></search><sort><creationdate>20200701</creationdate><title>Predictors of response after a second attempt of pharmacological labor induction: a retrospective study</title><author>Mariani, Luca Liban ; Mancarella, Matteo ; Fuso, Luca ; Novara, Lorenzo ; Menato, Guido ; Biglia, Nicoletta</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-60e1665a957c806822a25e0247f8cedd5eff13ccd0b71740e7a98dbef25dfac83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Apgar score</topic><topic>Cesarean section</topic><topic>Childbirth & labor</topic><topic>Endocrinology</topic><topic>Gynecology</topic><topic>Health risk assessment</topic><topic>Human Genetics</topic><topic>Induced labor</topic><topic>Maternal-Fetal Medicine</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Obstetrics/Perinatology/Midwifery</topic><topic>Response rates</topic><topic>Vagina</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mariani, Luca Liban</creatorcontrib><creatorcontrib>Mancarella, Matteo</creatorcontrib><creatorcontrib>Fuso, Luca</creatorcontrib><creatorcontrib>Novara, Lorenzo</creatorcontrib><creatorcontrib>Menato, Guido</creatorcontrib><creatorcontrib>Biglia, Nicoletta</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Archives of gynecology and obstetrics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mariani, Luca Liban</au><au>Mancarella, Matteo</au><au>Fuso, Luca</au><au>Novara, Lorenzo</au><au>Menato, Guido</au><au>Biglia, Nicoletta</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Predictors of response after a second attempt of pharmacological labor induction: a retrospective study</atitle><jtitle>Archives of gynecology and obstetrics</jtitle><stitle>Arch Gynecol Obstet</stitle><addtitle>Arch Gynecol Obstet</addtitle><date>2020-07-01</date><risdate>2020</risdate><volume>302</volume><issue>1</issue><spage>117</spage><epage>125</epage><pages>117-125</pages><issn>0932-0067</issn><eissn>1432-0711</eissn><abstract>Purpose
The aim of our study was to assess the outcomes of a prolonged induction carried out with a second sequential cycle of pharmacological stimulation after unsatisfactory response to a first attempt, and to highlight variables correlated with higher response rates.
Methods
A retrospective study was carried out on 157 women who underwent a two-step labor induction by vaginal prostaglandins followed by a second cycle of prostaglandins or intravenous oxytocin. Outcomes assessed were mode of delivery and maternal and neonatal morbidity. Main variables of pregnancy and delivery were collected to identify factors predicting the mode of delivery.
Results
Among 157 patients, 63 (40.1%) achieved a vaginal delivery, whereas 94 (59.9%) underwent Cesarean section, 9 women (5.7%) had postpartum hemorrhage; in 2 cases (1.3%), an Apgar score < 7 at 5 min from birth was reported. Higher risk of Cesarean section was observed with advanced maternal age (OR 1.13 for additional year, CI 1.04–1.22) and nulliparity (OR 8.84, CI 2.69–29.06), whereas the response rates were better in carriers of group B streptococcus colonization (OR 0.38, CI 0.17–0.84) and in women with favorable cervical status after the first stimulation (OR 0.81 for additional point of Bishop score, CI 0.70–0.94).
Conclusion
Labor induction with two cycles of pharmacological stimulation is a procedure with fairly good success rates and a low risk of maternal and neonatal complications. Factors predicting its success encompass younger age, parity, a positive recto-vaginal swab for group B streptococcus and a favorable cervix following the first cycle of stimulation.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>32445065</pmid><doi>10.1007/s00404-020-05578-3</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0003-1009-5309</orcidid></addata></record> |
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| ispartof | Archives of gynecology and obstetrics, 2020-07, Vol.302 (1), p.117-125 |
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| language | eng |
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| subjects | Apgar score Cesarean section Childbirth & labor Endocrinology Gynecology Health risk assessment Human Genetics Induced labor Maternal-Fetal Medicine Medicine Medicine & Public Health Obstetrics/Perinatology/Midwifery Response rates Vagina |
| title | Predictors of response after a second attempt of pharmacological labor induction: a retrospective study |
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