Victoire Delporte1, Anne Grabarz2, Nassima Ramdane3, Sophie Bodart2, Véronique Debarge4, Damien Subtil2, Charles Garabedian2. 1. CHU Lille, Jeanne de Flandre Hospital, Department of Obstetrics, F-59000 Lille, France. Electronic address: victoire.delporte@chru-lille.fr. 2. CHU Lille, Jeanne de Flandre Hospital, Department of Obstetrics, F-59000 Lille, France. 3. Univ. Lille, CHU Lille, EA 2694 - Public Health: Epidemiology and Quality of Patient Care, F-59000 Lille, France. 4. CHU Lille, Jeanne de Flandre Hospital, Department of Obstetrics, F-59000 Lille, France; University of Lille, EA 4489 - Perinatal Health and Environment, F-59000 Lille, France.
Abstract
INTRODUCTION: Evaluate the impact of labor induction on maternal complications following caesarean section during labor. MATERIAL AND METHODS: Retrospective, single-center study between 2015 and 2017. Were included singleton pregnancies who had cesarean section during labor after 37WG. Labor induction procedures included either transcervical balloon catheters or prostaglandins. Degree of emergency of the cesarean was decided according to color code (green, orange and red). We identified and compared intra and postoperative complications according to the mode of labor onset, and then to the mode of labor induction. RESULTS: 882 patients were included, 416 with spontaneous labor and 464 with labor induction. No significant difference was found for postoperative complications between the two groups. Patients with spontaneous labor had fewer green-code caesareans than patients with elective induction (29.3% vs. 40.3% p<0.001) and had more uterine pedicle injuries (6.3% vs. 3.0% p=0.022). Nevertheless, no difference was found for postpartum hemorrhage (PPH) between these two groups (41.59% vs. 43.32% p=0.60). The subgroup study of patients with labor induction showed that those necessitating 2 methods of labor induction had more severe PPH (22.2% vs. 8.1% p after Bonferroni correction = 0.002). CONCLUSIONS: Elective induction does not result in an increased risk of cesarean section during labor complications. Only the use of prostaglandin following transcervical balloon catheter increased the risk of severe postpartum hemorrhage.
INTRODUCTION: Evaluate the impact of labor induction on maternal complications following caesarean section during labor. MATERIAL AND METHODS: Retrospective, single-center study between 2015 and 2017. Were included singleton pregnancies who had cesarean section during labor after 37WG. Labor induction procedures included either transcervical balloon catheters or prostaglandins. Degree of emergency of the cesarean was decided according to color code (green, orange and red). We identified and compared intra and postoperative complications according to the mode of labor onset, and then to the mode of labor induction. RESULTS: 882 patients were included, 416 with spontaneous labor and 464 with labor induction. No significant difference was found for postoperative complications between the two groups. Patients with spontaneous labor had fewer green-code caesareans than patients with elective induction (29.3% vs. 40.3% p<0.001) and had more uterine pedicle injuries (6.3% vs. 3.0% p=0.022). Nevertheless, no difference was found for postpartum hemorrhage (PPH) between these two groups (41.59% vs. 43.32% p=0.60). The subgroup study of patients with labor induction showed that those necessitating 2 methods of labor induction had more severe PPH (22.2% vs. 8.1% p after Bonferroni correction = 0.002). CONCLUSIONS: Elective induction does not result in an increased risk of cesarean section during labor complications. Only the use of prostaglandin following transcervical balloon catheter increased the risk of severe postpartum hemorrhage.
Authors: Grażyna Bączek; Ewa Rzońca; Patryk Rzońca; Sylwia Rychlewicz; Margareta Budner; Agnieszka Bień Journal: Int J Environ Res Public Health Date: 2022-08-03 Impact factor: 4.614