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

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

Research output: Contribution to journalArticle

5 Scopus citations

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 - Feb 11 2002

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ASJC Scopus subject areas

  • Epidemiology
  • Pediatrics, Perinatology, and Child Health

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