Maternal and Perinatal Outcomes Amongst Nulliparous Singleton Pregnancies Electively Induced at 39 Weeks: A Prospective Observational Study.

ABSTRACT

Introduction: Given the uncertainty of inducing beyond 39 weeks, we intended to study the maternal and neonatal mortality and morbidity associated with planned elective induction of labour (eIOL) at 390/7 to 396/7 weeks. Objectives: To study the maternal and perinatal outcomes, after eIOL, at 390/7 to 396/7 weeks, amongst nulliparous singleton pregnancies, followed up for the duration of their hospital stay. Methods: All consecutive nulliparous, singleton gestations, undergoing eIOL, at 390/7 to 396/7 weeks, with no plan for caesarean section (CS) or contraindication for vaginal delivery were prospectively recruited. The primary outcome studied was the incidence of CS and neonatal intensive care requirement, and the secondary outcomes studied were induction-delivery interval, incidence of chorioamnionitis, postpartum haemorrhage, meconium aspiration syndrome (MAS), APGAR ≤ 7 at 1 min and neonatal mortality. Results: Amongst the total 304 mothers electively induced at 390/7 to 396/7 weeks, 80 (26.3%) mothers underwent CS and 48 (15.8%) neonates required intensive care. Fifteen (4.9%) babies required respiratory support at birth. The mean induction-delivery interval was 19 h 42 min ± 10 h. There were 9(3%) cases of PPH and no reported cases of chorioamnionitis. Eleven (3.6%) babies had an APGAR < / = 7 at 1 min and 9 (2.9%) had MAS, but there was no maternal or neonatal mortality. Conclusion: Induction of labour at 39 weeks in low-risk nulliparous women did not result in a lower frequency of CS or adverse perinatal outcomes.