BACKGROUND Prolonged pregnancy is the most frequent reason for induction of labor. This study aims to determine the effects of labor induction on delivery outcome and to quantify the risks of cesarean delivery associated with labor induction in post-date pregnancies. PATIENTS AND METHODS This retrospective case-control study included a total of 205 women who reached 42 weeks' gestation (41 weeks and 3 days) between January 2002 and April 2004 and who were scheduled for induction of labor with vaginal prostaglandins. These cases were matched for age and parity with controls in spontaneous labor beyond 41 weeks' gestation. Women with any additional medical or obstetric risk factors were excluded from the study. Maternal, neonatal and delivery outcomes were the main variables of interest. RESULTS During the study period the data of 410 women were available for analysis. Our data revealed that the use of amniotomy (p=0.02), oxytocin (p=0.006) and epidural analgesia (p=0.001) was increased significantly in the induction group compared with the control group of women with spontaneous onset of labor beyond term. The frequency of cesarean delivery and vacuum extraction was also significantly higher in the induction group (p=0.0001). The Bishop score before induction was an important factor that affected the delivery outcome, resulting in significantly higher rates of cesarean section and vacuum extraction when the score was unfavorable (p=0.0001). A univariate regression model revealed induction per se (p=0.0001), primiparity (p= 0.0001), increased maternal age (p=0.006) and an unfavorable Bishop score (p=0.0001) as statistically significant risk factors for cesarean section. In a multivariate logistic regression model, primiparity (p=0.03), increased maternal age (p=0.02) and an unfavorable Bishop score (p=0.01) remained independent risk factors for cesarean section. High infant birth weight was also an independent risk factor (p=0.03). CONCLUSIONS Our data suggest that women undergoing labor induction because of prolonged pregnancy should be sufficiently informed regarding the risks of a cesarean section or a vacuum extraction. Furthermore, the option of elective cesarean section should be considered, particularly in primiparous women with an unfavorable cervix, higher age, and high estimated infant birth weight.

中文翻译：

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引产对长时间妊娠患者产科结局的影响：选择性引产与足月自然分娩的比较。

背景技术长时间怀孕是引产的最常见原因。本研究旨在确定引产对分娩结局的影响，并量化与妊娠后分娩引产相关的剖宫产风险。病人和方法这项回顾性病例对照研究包括2002年1月至2004年4月之间共计妊娠42周（41周零3天）的205名妇女，她们计划使用阴道前列腺素引产。这些病例的年龄和均等水平与妊娠41周后自发分娩的对照组相匹配。排除任何具有其他医学或产科危险因素的女性。产妇，新生儿和分娩结局是关注的主要变量。结果在研究期间，有410名妇女的数据可供分析。我们的数据显示，与自发性自足分娩的孕妇相比，诱导组的羊膜切开术（p = 0.02），催产素（p = 0.006）和硬膜外镇痛（p = 0.001）的使用率显着增加。诱导组剖宫产和抽真空的频率也明显更高（p = 0.0001）。诱导前的Bishop评分是影响分娩结果的重要因素，当评分不佳时，会导致剖宫产和抽真空的发生率显着提高（p = 0.0001）。单变量回归模型显示出诱导本身（p = 0.0001），初产（p = 0.0001），产妇年龄增加（p = 0.006）和不利的Bishop评分（p = 0。0001）作为剖宫产的统计学显着危险因素。在多变量logistic回归模型中，剖宫产的胎盘早孕（p = 0.03），产妇年龄增加（p = 0.02）和Bishop评分不良（p = 0.01）仍然是独立的危险因素。婴儿高出生体重也是一个独立的危险因素（p = 0.03）。结论我们的数据表明，因长时间妊娠而引产的妇女应充分了解剖宫产或抽真空的风险。此外，应考虑选择剖宫产的选择，尤其是在子宫颈不良，年龄较大且估计婴儿出生体重较高的初产妇女中。02）和不良的Bishop评分（p = 0.01）仍然是剖宫产的独立危险因素。婴儿高出生体重也是一个独立的危险因素（p = 0.03）。结论我们的数据表明，因长时间妊娠而引产的妇女应充分了解剖宫产或抽真空的风险。此外，应考虑选择剖宫产的选择，特别是在子宫颈不良，年龄较大且估计婴儿出生体重较高的初产妇女中。02）和不良的Bishop评分（p = 0.01）仍然是剖宫产的独立危险因素。婴儿高出生体重也是一个独立的危险因素（p = 0.03）。结论我们的数据表明，因长时间妊娠而引产的妇女应充分了解剖宫产或抽真空的风险。此外，应考虑选择剖宫产的选择，特别是在子宫颈不良，年龄较大且估计婴儿出生体重较高的初产妇女中。结论我们的数据表明，因长时间妊娠而引产的妇女应充分了解剖宫产或抽真空的风险。此外，应考虑选择剖宫产的选择，特别是在子宫颈不良，年龄较大且估计婴儿出生体重较高的初产妇女中。结论我们的数据表明，因长时间妊娠而引产的妇女应充分了解剖宫产或抽真空的风险。此外，应考虑选择剖宫产的选择，特别是在子宫颈不良，年龄较大且估计婴儿出生体重较高的初产妇女中。