Obesity and cervical ripening failure risk

Gauthier, Tristan; Mazeau, Sophie; Dalmay, François; Eyraud, J.-P.; Catalan, C.; Marin, Benoît; Aubard, Y.

doi:10.3109/14767058.2011.575485

Cited by 28 publications

(27 citation statements)

References 15 publications

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“…An additional 49 studies were excluded for the following reasons: not focused on induction of labor (n = 27), BMI not stratified (n = 12), no details for induction of labor protocol (n = 7), included only nulliparous women (n = 2), used nonstandard BMI categorizations (n = 1). Ten studies remained for the analysis …”

Section: Resultsmentioning

confidence: 99%

“…Eight of the 10 studies reporting outcomes of cesarean births were included in the meta‐analysis (n = 5450 participants). Five of the included studies were conducted in the United States; the remaining studies were carried out in Israel, Ireland, France, and Canada (Table ). The studies included in this review scored between 7 and 9 stars on the Newcastle‐Ottawa scale, indicating high quality .…”

Section: Resultsmentioning

confidence: 99%

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Influence of Maternal Obesity on Labor Induction: A Systematic Review and Meta‐Analysis

Ellis¹,

Brown²,

Barger³

et al. 2019

J Midwife Womens Health

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Introduction: Studies have shown that women with obesity have longer labors. The purpose of this systematic review and meta-analysis is to examine existing evidence regarding labor induction in women with obesity, including processes and outcomes. The primary outcome was cesarean birth following labor induction. Secondary outcomes were the timing and dosage of prostaglandins, the success of mechanical cervical ripening methods, and synthetic oxytocin dose and timing. Methods: Searches were performed in PubMed MEDLINE, Embase, CINAHL, EBSCO, the Cochrane Database of Systematic Reviews, the Database of Abstracts of Effects, Google Scholar, and ClinicalTrials.gov. Searches were limited to studies published in English after 1990. Ten studies published between 2009 and 2017 were included in this review. All were observational studies comparing processes and outcomes of induction of labor in relation to maternal body mass index. The primary outcome was cesarean birth following labor induction. We assessed heterogeneity using Cochran’s Q test and tau-squared and I2 statistics. We also calculated fixed-effect models to estimate pooled relative risks and weighted mean differences. Results: Ten cohort studies met inclusion criteria; 8 studies had data available for a meta-analysis of the primary outcome. Cesarean birth was more common among women with obesity compared with women of normal weight following labor induction (Mantel-Haenszel fixed-effect odds ratio, 1.82; 95% CI, 1.55–2.12; P < .001). Maternal obesity was associated with a longer time to birth, higher doses of prostaglandins, less frequent success of cervical ripening methods, and higher dose of synthetic oxytocin, as well as a longer time to birth after oxytocin use. Discussion: Women with obesity are more likely than women with a normal weight to end labor induction with cesarean birth. Additionally, women with obesity require longer labor inductions involving larger, more frequent applications of both cervical ripening methods and synthetic oxytocin.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Influence of Maternal Obesity on Labor Induction: A Systematic Review and Meta‐Analysis

Ellis¹,

Brown²,

Barger³

et al. 2019

J Midwife Womens Health

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show abstract

“…25 In a retrospective study of 95 obese patients matched to 190 nonobese patients undergoing IOL, the obese women were significantly more likely to fail cervical ripening (defined as a persistent Bishop score <6) with a dinoprostone tampon or gel than the nonobese women (53.7% vs. 34.2%, P = 0.0016). 26 In another study of term nulliparous women undergoing IOL, obese women were significantly less successful at achieving VD when the Bishop score was <3 (39% vs. 57%, P<0.05), but not when the Bishop score was Z3. In addition, a greater percentage of obese women were admitted with Bishop scores <3 in the obese group as compared with nonobese group (25% vs. 14%, P<0.001).…”

Section: Induction Of Labormentioning

confidence: 96%

Intrapartum Management of the Obese Gravida

Carpenter¹

2016

Clinical Obstetrics &Amp; Gynecology

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Obese women are at increased risk for multiple labor abnormalities, including postdates pregnancy, failed induction of labor, prolonged labor, cesarean delivery, and postpartum hemorrhage (PPH). Prolonged labor among obese women is confined to the first stage of labor. In the setting of reassuring fetal and maternal status, increased time to progress in the first stage of labor should be allowed. Uterine atony occurs more frequently in obese women and vigilance in the prevention of PPH is critical. There is a lack of high-quality data to guide the management of induction, labor, and PPH prevention among obese women.

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“…En effet, le dé clenchement du travail expose à un risque plus é levé d'accouchement par cé sarienne [18] et les deux principaux facteurs pré dictifs de succè s du dé clenchement sont la parité et la maturité cervicale é valué e par le score de Bishop. D'autres facteurs rentrent en compte tels que le poids foetal, l'IMC et l'âge maternel [15,16,19]. La plupart des é tudes ré centes, é valuant l'efficacité des prostaglandines et des mé thodes mé caniques dans la maturation cervicale, porte sur des patientes ayant un score de Bishop 6 [11,12,[20][21][22], seuls Pennell et al se concentrent sur les patientes avec un score de Bishop 4 [23].…”

Section: Discussionunclassified

“…Parmi les facteurs pronostiques d'é chec de maturation, plusieurs auteurs retrouvent un score de Bishop 3 [15,16]. Nous avons souhaité nous focaliser sur ces patientes pré sentant des conditions locales trè s dé favorables (Bishop 3), ce qui est original car la plupart des é tudes porte sur des femmes ayant un Bishop 6.…”

Section: Introductionunclassified