European Journal of Molecular & Clinical Medicine

Background – Induction of labor is defined as iatrogenic stimulation of uterine contractions to cause the delivery of fetus before the onset of spontaneous labor. Since Labour induction is among the common and widely practiced obstetric interventions aiming at achieving the vaginal delivery,it is necessaryto find out the factors responsible for cesarean delivery in induced labor at term, as risk factors in terms of sociodemographic characteristics of pregnant females.
Methods – Prospective analysis of 120 Study subjects who were having singleton live fetus in cephalic position and at gestational age equal to or more than 37 weeks were included in our study. A pre-formed written consent was also taken from study subjects.
Results – Sociodemographic factors of study subjects were the risk factors in cesarean delivery in induced labor at term, besides the obstetric risk factors. In patients undergoing labor induction, primiparity, urban residence, working women, higher socioeconomic status were found to associated with an elevated risk of cesarean delivery.

 
Introduction: The rate of maternal and perinatal complications increases after 39 weeks’ gestation.^[1] Growing body of evidence supports improved or not worsened birth outcomes with non-medically indicated induction of labor at 39 weeks gestation compared with expectant management. This evidence includes 2 recent randomized control trials.^[2-4] This study was conducted to evaluate whether induction of labor at 39 weeks improves perinatal and maternal outcomes in women with low risk pregnancy compared with  induction of labor at 40 + weeks.
Materials and Methods: This was a retrospective observational study in a rural teaching hospital in Mandya, Karnataka, India. The study population was 280 low risk women with an uncomplicated singleton pregnancy induced at 39 weeks (Group A, n=141) versus induction at 40 completed weeks of gestation (Group B, n=139). The data was retrieved from medical records department from January 2021 to April 2022. Mode of birth and other maternal and perinatal outcomes were described in each group, for women who underwent induction of labor at 39 weeks, and for women who gave birth from 40 completed weeks onward. The primary outcome included various modes of delivery. Secondary outcomes included maternal outcome and neonatal morbidity.
Results: In the current study, elective induction at 39 weeks gestation versus elective induction at 40 weeks gestation was compared. Induction at 39 weeks was associated with a decreased likelihood of cesarean birth (17.7% versus 23.7%) and a comparable increase in rate of operative vaginal birth (9.2% vs 10.7%)(p value<0.001). Indication for cesarean delivery in the majority of the study participants in Group A 44% was non-reassuring fetal status while in Group B 45.45% was secondary arrest of cervical dilatation (p value<0.001). An increased incidence of meconium stained amniotic fluid was noted in 19.4% among Group B participants compared to 14.1% in Group A (p value <0.001). In Group A 95.7% of the babies had an APGAR score of 7 at birth and in Group B 90.6% had an APGAR score of 7 at birth (p value <0.001). There was 1.4% neonatal NICU admission in Group A with 0.7% requiring respiratory support (p value<0.001). There was 5.03% neonatal NICU admission in Group B with 2.8% requiring respiratory support (p value<0.001). Term elective induction was associated with a statistically significant decrease in adverse newborn infant outcomes.
Conclusion: Elective induction of labor at 39 weeks gestation is associated with a decrease in cesarean birth and operative delivery and improved neonatal outcomes.

Labor induction rates have more than doubled in the United States over the last two
decades. Indications and risk factors for induction of labor are also gaining in
popularity. Professional organizations such as the American College of
Obstetricians and Gynecologists and The Joint Commission have taken steps to
discourage elective induction of labor prior to 39 weeks' gestation and have defined
new terms such as early-term, full-term, late-term, and postterm gestation to assist
clinicians in determining the appropriate timing of birth for specified indications.
Induction of labor carries the risk of harm to both the mother and her fetus. The
cost of inducing labor and its influence on the health care system are a major
source of worry. Women's education and the shared decision-making process used
to get informed permission are critical elements in lowering early elective deliveries.
The use of scheduling forms, hard stop procedures, induction of labor indication
tools, and informed consents may assist the provider in reducing overdiagnosis,
overtreatment, and disease creep. This article discusses induction of labor trends,
medical indications and criteria, related dangers, cost and health system impact,
and measures to reduce induction of labor.

Object: The study causal factors, as well as obstetrics outcomes of labor in women with premature rupture of membranes and tactics of labor management.
Subject and methods: The study material was the history of childbirth of 106 pregnant women in whom labor was complicated by premature rupture of the membranes in the period from 22-36 weeks of gestation, delivery in the Bukhara regional perinatal center for the period 2017-2019.
Results: This article presents the results of a retrospective study in which childbirth was complicated by premature rupture of the membranes. The results show the significant role of premature rupture of the membranes in the development of obstetrics complications, especially in women with aggravated somatic and gynecological anamnesis.
Conclusion: Premature discharge of amniotic fluid, as a result of pathological growth of conditionally pathogenic microbiocenosis of cervico-vaginal, which was the cause of chorioamnionitis, which contributed to a significant increase in the specific frequency of obstetrics pathologies.