Physicians who induce labor for fetal macrosomia do not reduce cesarean delivery rates

Journal of Perinatology : Official Journal of the California Perinatal Association
T J Horrigan

Abstract

To determine whether obstetricians with high rates of induction for the indication of fetal macrosomia had higher or lower cesarean section rates. Data were analyzed from 1432 deliveries with birthweights > 4000 g. Four physician populations were identified: a faculty service and three groups of private practitioners with induction rates 20% to 40%, 40% to 60% and > 60%. The average cesarean section rate was determined for each group as well as the percentage of each group's deliveries occurring before 39 weeks, at 39, at 40, and after 40 weeks. In addition, the relative risk of cesarean delivery was calculated for the entire study population. No correlation was found between the rate of induction of labor and the rate of cesarean section. Delivery of nulliparous and multiparous patients after 40 weeks carried an increased risk of cesarean section. Delivery of multiparous patients before 39 weeks did also. Obstetricians with induction rates > 40% significantly decreased the incidence of delivery after 40 weeks, which lowered their cesarean section rates, but no net lowering occurred because of increased rate of cesarean section < 39 weeks. A fetal weight of 4000 g or more is not an indication for induction of labor. For multipa...Continue Reading

References

Jan 1, 1995·American Journal of Perinatology·C D FriesenW F Rayburn
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Citations

Aug 8, 2014·Obstetrical & Gynecological Survey·A Cristina RossiFederico Prefumo
Jun 3, 2014·BMC Pregnancy and Childbirth·Françoise VendittelliUNKNOWN Audipog Sentinel Network
Feb 13, 2016·Journal of Midwifery & Women's Health·Ellen M Ray, Jeanne L Alhusen
Dec 3, 2003·Journal of Obstetric, Gynecologic, and Neonatal Nursing : JOGNN·Kathleen Rice Simpson, Jana Atterbury
Nov 19, 2004·International Journal of Gynaecology and Obstetrics : the Official Organ of the International Federation of Gynaecology and Obstetrics·N E StotlandG J Escobar
Apr 4, 2006·Obstetrics and Gynecology·Rhona MahonyColm O'Herlihy
Jun 1, 2005·The Journal of Perinatal & Neonatal Nursing·Kathleen Rice Simpson, Kathleen E Thorman

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