Labor Progresses Differently for Induced Versus Spontaneous Delivery in Nulliparous Women

Washington, DC—Is there a difference in the labor progression of nulliparous women in induced versus spontaneous labor? Investigators from St Luke’s Roosevelt Hospital in New York say that there is.

In a study presented by Hasra K. Philip, MD, MPH, at the 2011 meeting of the American College of Obstetricians and Gynecologists, this question was evaluated in a prospective study of 195 women presenting for delivery over a 4-month period.

“Our findings suggested that the progression of an induced labor differs from spontaneous labor in nulliparous women,” Dr Philip said.

The researchers found absolute indications for induction in 25% of the women, and relative indications in 65%. Method of delivery for the spontaneous labor group (n = 71) was vaginal in 83%, operative vaginal in 22%, and cesarean section in 19%. For the induced labor group (n = 124), 27% had vaginal delivery, 5% had operative vaginal delivery, and 29% underwent cesarean section. This yielded a significant 2.66 increased risk for having a cesarean delivery among the induced group, Dr Philip reported.

Induced nulliparous women had a significantly shorter active phase of labor: 3.9 hours versus 5.4 hours. The second stage of labor in induced women was also significantly shorter: 1.3 hours versus 1.8 hours. No significant difference was seen in the duration of the latent phase of labor, which was 9.1 hours for the induced group and 10.2 hours in the spontaneous group. “The traditional Friedman labor curve developed for nulliparous women may not apply, therefore, to induced patients,” Dr Philip concluded.