Labor induction: change of indications and outcomes over time and future trends — a retrospective analysis

Abstract

Labor induction: change of indications and outcomes over time and future trends — a retrospective analysis Aida Omerović1,† , Sandra Pajek1,† , Veronika Anzeljc2 , Faris Mujezinović1,2,* 1Department of Perinatology, Faculty of Medicine University of Maribor, 2000 Maribor, Slovenia 2Department of Perinatology, University Medical Centre Maribor, 2000 Maribor, Slovenia *Correspondence: faris.mujezinovic@ukc-mb.si (Faris Mujezinović) †These authors contributed equally. Academic Editor: Paolo Ivo Cavoretto Submitted: 7 October 2021 Revised: 1 November 2021 Accepted: 4 November 2021 Published: 26 April 2022 Abstract Background: The purpose of this study was to evaluate the results of induction of labor over time in order to identify future trends. Methods: Data were collected from a national database for University Medical Center Maribor on the pregnant women demographics, the indications for labor induction, the process of induction and delivery, and the outcomes of delivery for periods 2011‒14 and 2015‒18. Results: In the second period (2015‒18), the rate of labor induction increased (14.7% vs. 19.0%, p < 0.00001), pregnant women were older (29.7 years vs. 30.0 years, p = 0.0018), were more frequently monitored in tertiary hospitals during pregnancy (40.6% vs. 80.7%, p < 0.00001), had hypertension in pregnancy (5.4% vs. 2.7%, p = 0.0002), and oligohydramnios (9.6% vs. 6.9% , p = 0.007). During labor, amniotomies (60.3% vs. 53.7%, p = 0.0004), umbilical cord prolapses (1.2% vs. 0.1%, p = 0.0003), meconium amniotic fluids (12.7% vs. 8.8%, p = 0.0008), pathological CTG tracings (15.2% vs. 8.4%, p < 0.00001) were less frequent. There were less episiotomies (37.4% vs. 29.1%, p < 0.00001), vacuum extractions (4.2% vs. 2.8%, p = 0.049), while the rate of caesarean sections remained constant (15.0% vs. 16.6%, p = 0.23). Conclusions: There is a tendency toward increased induction of labor (IOL) rates, probably related to higher average age of women, but with better delivery outcomes. Our findings reflect local practice and cannot be generalized. Keywords: postterm pregnancy; induction of labor; indications; outcomes; trends of induction