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Induction of Labor Compared With Expectant Management and Risk of Cesarean Delivery in Obese Women [7F]

Staudenmaier, Emily K. DO; Chatterton, Carolyn G. DO, MPH; Montanez, Marelli DO; Sampino, Isabella; Vullo, John J. DO; Gurram, Padmalatha MD, MSCTR

doi: 10.1097/01.AOG.0000559039.56251.f2
Friday, May 3, 2019

INTRODUCTION: Obesity is a known independent risk factor for stillbirth. The obesity related stillbirth risk increases with advancing gestational age. There is no clear consensus regarding antepartum surveillance to reduce the risk of stillbirth. Therefore, the timing of delivery is a concern for the obstetric provider. The purpose of this study is to determine if obesity increases cesarean delivery rates in elective inductions at term when compared to expectant management. Antepartum, intrapartum, and neonatal complications were also compared between the groups.

METHODS: This is a retrospective chart review of women delivered after 37 weeks gestation and with a BMI greater than 30 kg/m2 between 2015-2016 at our institution. Women admitted for elective induction of labor (N=104) were compared to those admitted in spontaneous labor (N=144). Medical indications for inductions of labor, malpresentation, fetal anomalies, and multiple gestations were excluded. Institutional Review Board approval was obtained.

RESULTS: Maternal characteristics were similar between the two groups (p>0.05). There were no significant differences in antepartum, intrapartum and neonatal complications between the groups (p>0.05). There are no stillbirths in either group. The rate of cesarean delivery is significantly higher (p=0.029) for patients admitted for elective induction (43.3%) compared to those admitted in spontaneous labor (27.8%).

CONCLUSION: Expectant management in obese women is associated with decreased rates of cesarean delivery without increased incidence of adverse outcomes compared to elective induction of labor.

Good Samaritan Hospital Medical Center, West Islip, NY

Financial Disclosure: The authors did not report any potential conflicts of interest.

© 2019 by the American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.