According to
statistics by CDC, 23.3% of women in USA undergo induction of labor making it
one of the most common obstetric procedure performed in US hospitals.
A study presented
at the 37th
annual meeting of Society for Maternal-Fetal Medicine , January 23-28 , Las
Vegas by Dr. Tetsuya Kawakita and his
colleagues sought to develop a model
that could predict the likelihood of successful
induction of labor. [1]
The researchers
used data from Consortium on Safe labor study, a retrospective multicenter
study that extracted data on labor and delivery across 19 hospitals in United states.
[2]
Of 12,413 nulliparous
women at ≥37 weeks’ gestation who had labor undergone induction, 9,550 (76.9%) delivered
vaginally.
The researchers
studied the various demographic, obstetric and neonatal factors in these study
group and by running stepwise logistic regression were able to identify factors
associated with successful vaginal birth.
The maternal
factors were maternal age, BMI, race, weeks at induction, gestational diabetes
or prediabetes, cervical dilatation, effacement and consistency. Fetal factors were station of fetal head,
amount of liquor, IUGR and CTG at the beginning of the procedure. Taking all
these factors into account a Nomogram was created, each maternal factor was allotted
a fixed number of points. A maternal BMI of 70 received 8 points while a BMI of
20 received 95 points. Similarly, if maternal age at labor was 45 she received
4 points while 25 points were given if her age was 20.
The total
points were calculated with a maximum of 317 points. The higher the number of points
the patient received, the probability of vaginal delivery also increased.
 |
| Adapted from SMFM 2017 abstracts |
