TITLE:
Induction of Labor at 39 Weeks versus Expecting Labour till 41 Weeks: Randomized Controlled Trial on Class I Obese Egyptian Women, with Mode of Delivery Being a Study Endpoint
AUTHORS:
M. Samy, Sarah Safwat
KEYWORDS:
Obesity, Induction, Cesarean Section, Vaginal, Delivery
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.9 No.6,
June
21,
2019
ABSTRACT: Background: Maternal obesity is reported to be associated with increased incidence
of gestational diabetes mellitus and hypertension. These cause failure of
labour induction, leading to higher incidence of cesarean section (CS). The aim
of this study was to assess which reduces CS rate, labor induction at 39 weeks
or leaving women for spontaneous labor onset till 41 weeks. Methodology: A randomized controlled
trial was conducted in Ain Shams Maternity Hospital in Egypt from 2016 to 2018.
Study population consisted of 200 term primigravida pregnant obese women
delivered in Ain Shams Maternity Hospital. They were divided into two groups:
Group A: induction of labor at 39 + 0 weeks (n = 100) by vaginal administration
of 25 μg misoprostol (PGE1) every 6 hours for 5 doses; Group B: waiting
spontaneous labor onset till 41 + 0 weeks (n = 100), and if no spontaneous
labor occurred at 41 weeks, induction was performed in the same way. Results: Induction (Group A) vs. waiting spontaneous labor (Group B) showed the
followings, which were significant: CS: 22% vs 39%, p = 0.009; maternal birth injury:
4% vs 12%, p = 0.037; non-assisted vaginal deliveries: 93.6% vs 78.7%, p = 0.034;
APGAR scores at 1 & 5 min: 7.6 ± 0.8 vs 7.3 ± 1.1 p = 0.038, 8.4 ± 1.0 vs
8.1 ± 1.3 p = 0.040, respectively; birth weight; 3.3 ± 0.1 vs 3.5 ± 0.2 kg, p
Conclusion: CS rate was significantly lower in women with induction of
labor at 39 weeks than those waiting for spontaneous labor onset till 41 weeks
in obese Egyptian pregnant women.