Indications and results of labour induction in nulliparous women: An interview among obstetricians, residents and clinical midwives

Jorik Vellekoop*, Francis P.J.M. Vrouenraets, Jan Willem van der Steeg, Ben W.J. Mol, Frans J.M.E. Roumen

*Corresponding author for this work

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Objective: To investigate which clinical factors are important in management decisions that clinicians make in the process of labour induction, and which clinical factors they estimate as predictive of labour outcome after induction. Study design: A written interview was conducted among obstetricians, residents and clinical midwives in five teaching hospitals in the south of the Netherlands. Sixteen fictive vignettes were constructed of pregnant nulliparous women who were candidates for induction of labour. The vignettes differed on eight clinical variables: maternal age, BMI, gestational age, indication for induction (maternal request vs mild pre-eclampsia), dilation, position, consistency and effacement of the cervix. For each case presentation, the inclination to induce labour was calculated for the three groups, and their estimates of the probability of a spontaneous vaginal delivery or a caesarean delivery were analyzed. Results: Of the 80 questionnaires sent, 60 (75%) were completed. Mild pre-eclampsia and post-term pregnancy were the most important clinical factors for the decision to induce or not in all three groups. Gestational age, effacement and dilation of the cervix were considered as the most important predictors of labour outcome after induction. Conclusions: In this interview, obstetricians, residents and clinical midwives based their decision-making whether or not to induce labour predominantly on medical indications. Outcome of labour after induction was estimated to depend on gestational age and cervical status at the start of induction.

Original languageEnglish
Pages (from-to)156-159
Number of pages4
JournalEuropean Journal of Obstetrics and Gynecology and Reproductive Biology
Volume146
Issue number2
DOIs
Publication statusPublished - Oct 2009

Keywords

  • Bishop score
  • Interview
  • Labour induction
  • Prediction
  • Prognostic factor

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