Elective Induction of Labor in Normal pregnant Multiparous Women at 39 Weeks Versus Expectant Management; Randomized Controlled Trial

Abstract

Background: The physiological and anatomical mechanisms interacting to maintain pregnancy and trigger the labor process are far complex and require research efforts that could elucidate the factors that could trigger the physiological gradual cervical effacement and dilatation that would finally result in delivery at appropriate timing without jeopardization of maternal and fetal clinical situations. Aim of the Work: to compare the clinical outcomes of elective induction of labor at 39 weeks in multiparous women versus expectant management. Patients and Methods: A prospective clinical research study recruited 150 research study subjects, inclusive research criteria research criteria involved the following Normal pregnant multiparous women, Sure of dates and confirmed by sonography, gestational age 39-40+6 weeks, singleton pregnancy, Age range from 20 to 40 years, reactive fetal non-stress test. Exclusive research criteria involved the presence of any contraindication for vaginal delivery (e.g. placenta Previa, accrete … etc.) contraindications for induction of labor (e.g. fetal malpresentation, prior uterine surgery), cases having active labor, antepartum hemorrhage, eclampsia, cases having hemolysis, elevated liver enzymes and low platelets, clinically suspected chorioamnionitis, IUGR, multiple gestation, non-reassuring fetal heart rate, IUFD, cases that refused to participate in the research study, cases have been randomized into two equal numbered research groups the induction and spontaneous research groups. Results: CS was statistically significantly most frequent in selective induction research group (p value=0.001) with no statistical significant difference between elective induction and spontaneous onset research groups interestingly it was revealed as regards the Value of Elective Induction over Selective Induction that the rate of elevation = 36.4%, efficacy =65.6%, relative rate =1.66, number needed to treat =2.7. Conclusions: The current study have revealed that the cesarean section deliveries are more statistically significantly higher among patients of selective induction whereas elective and spontaneous groups didn’t show any difference denoting that elective induction is a mode of management that doesn’t raise the rates of cesarean section besides it was observed to be safe as regards the maternal and neonatal clinical outcomes.