INDUCTION OF LABOR IN THE 90S - CONQUERING THE UNFAVORABLE CERVIX

Objective: To determine the efficacy, safety, and duration of induced labor using an integrative approach (prostaglandin, amniotomy, oxytoci n) and to depict these findings graphically. Methods: Five hundred nin ety-seven pregnancies requiring induction of labor between October 199 3 and May 1995 were analyzed prospectively. Patients were categorized by Bishop score at entry and by parity for comparison of success of in duction, maternal and fetal complications, and duration of labor. Resu lts: The women who had a Bishop score at entry of 3 or less had signif icantly higher rates of failed induction (9.4 versus 0.7%, P < .01) an d of cesarean delivery (29 versus 15.4%, P < .01) than those with a Bi shop score above 3. Compared with spontaneous labor, the rates of cesa rean delivery in induced labor remained significantly elevated. Compli cations of induction were infrequent, regardless of Bishop score. The time from initiation of induction to achievement of active phase was s ignificantly longer in women with lower Bishop scores. Conclusion: Reg ardless of cervical status and parity, vaginal delivery can be anticip ated in the majority of patients undergoing labor induction. The induc tion characteristics described may assist in the management of induced labor. (C) 1997 by The American College of Obstetricians and Gynecolo gists.