Reducing the caesarean delivery risk in elective inductions of labour: A decision analysis

Jennifer L. Bailit, Stephen Downs, John M. Thorp

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

To determine whether the vaginal delivery rate is increased in nulliparous women who have positive fetal fibronectin (fFN) testing before elective induction of labour, we performed a decision analysis that tested three options: (1) spontaneous labour; (2) testing nulliparous candidates for elective induction of labour at 39 weeks gestation with fFN and inducing labour if fFN positive (women who are fFN negative are managed expectantly); (3) elective induction of labour for women who are at least 39 weeks. We found that spontaneous labour had a vaginal delivery rate of 90%, elective induction 79% and fFN screening 83%. At baseline, a mother must be willing to take an additional 7% risk of caesarean delivery to warrant fFN testing or an additional 11% risk of caesarean delivery to warrant elective induction. We conclude that spontaneous labour has the highest vaginal delivery rates. An fFN test in a nulliparous woman may help to raise her likelihood of a vaginal delivery in an elective induction.

Original languageEnglish (US)
Pages (from-to)90-96
Number of pages7
JournalPaediatric and Perinatal Epidemiology
Volume16
Issue number1
DOIs
StatePublished - 2002
Externally publishedYes

Fingerprint

Induced Labor
Decision Support Techniques
Fibronectins
Mothers
Pregnancy

ASJC Scopus subject areas

  • Epidemiology
  • Pediatrics, Perinatology, and Child Health

Cite this

Reducing the caesarean delivery risk in elective inductions of labour : A decision analysis. / Bailit, Jennifer L.; Downs, Stephen; Thorp, John M.

In: Paediatric and Perinatal Epidemiology, Vol. 16, No. 1, 2002, p. 90-96.

Research output: Contribution to journalArticle

@article{7bb8c3bc8aac4dde97cb804faf61aea0,
title = "Reducing the caesarean delivery risk in elective inductions of labour: A decision analysis",
abstract = "To determine whether the vaginal delivery rate is increased in nulliparous women who have positive fetal fibronectin (fFN) testing before elective induction of labour, we performed a decision analysis that tested three options: (1) spontaneous labour; (2) testing nulliparous candidates for elective induction of labour at 39 weeks gestation with fFN and inducing labour if fFN positive (women who are fFN negative are managed expectantly); (3) elective induction of labour for women who are at least 39 weeks. We found that spontaneous labour had a vaginal delivery rate of 90{\%}, elective induction 79{\%} and fFN screening 83{\%}. At baseline, a mother must be willing to take an additional 7{\%} risk of caesarean delivery to warrant fFN testing or an additional 11{\%} risk of caesarean delivery to warrant elective induction. We conclude that spontaneous labour has the highest vaginal delivery rates. An fFN test in a nulliparous woman may help to raise her likelihood of a vaginal delivery in an elective induction.",
author = "Bailit, {Jennifer L.} and Stephen Downs and Thorp, {John M.}",
year = "2002",
doi = "10.1046/j.1365-3016.2002.391_1.x",
language = "English (US)",
volume = "16",
pages = "90--96",
journal = "Paediatric and Perinatal Epidemiology",
issn = "0269-5022",
publisher = "Wiley-Blackwell",
number = "1",

}

TY - JOUR

T1 - Reducing the caesarean delivery risk in elective inductions of labour

T2 - A decision analysis

AU - Bailit, Jennifer L.

AU - Downs, Stephen

AU - Thorp, John M.

PY - 2002

Y1 - 2002

N2 - To determine whether the vaginal delivery rate is increased in nulliparous women who have positive fetal fibronectin (fFN) testing before elective induction of labour, we performed a decision analysis that tested three options: (1) spontaneous labour; (2) testing nulliparous candidates for elective induction of labour at 39 weeks gestation with fFN and inducing labour if fFN positive (women who are fFN negative are managed expectantly); (3) elective induction of labour for women who are at least 39 weeks. We found that spontaneous labour had a vaginal delivery rate of 90%, elective induction 79% and fFN screening 83%. At baseline, a mother must be willing to take an additional 7% risk of caesarean delivery to warrant fFN testing or an additional 11% risk of caesarean delivery to warrant elective induction. We conclude that spontaneous labour has the highest vaginal delivery rates. An fFN test in a nulliparous woman may help to raise her likelihood of a vaginal delivery in an elective induction.

AB - To determine whether the vaginal delivery rate is increased in nulliparous women who have positive fetal fibronectin (fFN) testing before elective induction of labour, we performed a decision analysis that tested three options: (1) spontaneous labour; (2) testing nulliparous candidates for elective induction of labour at 39 weeks gestation with fFN and inducing labour if fFN positive (women who are fFN negative are managed expectantly); (3) elective induction of labour for women who are at least 39 weeks. We found that spontaneous labour had a vaginal delivery rate of 90%, elective induction 79% and fFN screening 83%. At baseline, a mother must be willing to take an additional 7% risk of caesarean delivery to warrant fFN testing or an additional 11% risk of caesarean delivery to warrant elective induction. We conclude that spontaneous labour has the highest vaginal delivery rates. An fFN test in a nulliparous woman may help to raise her likelihood of a vaginal delivery in an elective induction.

UR - http://www.scopus.com/inward/record.url?scp=0036154607&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0036154607&partnerID=8YFLogxK

U2 - 10.1046/j.1365-3016.2002.391_1.x

DO - 10.1046/j.1365-3016.2002.391_1.x

M3 - Article

C2 - 11862951

AN - SCOPUS:0036154607

VL - 16

SP - 90

EP - 96

JO - Paediatric and Perinatal Epidemiology

JF - Paediatric and Perinatal Epidemiology

SN - 0269-5022

IS - 1

ER -