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Induction or Augmentation of Labor Raises Risk of Chorioamnionitis: Presented at ACOG

By Maggie Schwarz

WASHINGTON, D.C. -- May 10, 2006 -- Both augmentation and induction of labor raise the risk of infection in the newborn, according to a study presented here at the 54^th Annual Clinical Meeting of the American College of Obstetricians and Gynecologists (ACOG).

Thomas D. Myles, MD, professor of obstetrics and gynecology, division of maternal-fetal medicine, St. Mary's Health Center, St. Louis, Missouri, presented results from a study which measured the chorioamnionitis rate with induction and augmentation of labor.

Dr. Myles conducted a retrospective review of delivery records for 7,377 patients attempting a vaginal delivery from 1996 to 1999. Records were evaluated for augmentation of labor and induction of labor, as well as method of labor induction. Demographic data, delivery routes and chorioamnionitis rates were determined and infection rates between induction and augmentation of labor compared against the 5651 control subjects.

There were 1717 (23.3%) patients who underwent labor induction, 1159 with oxytocin, 457 with misoprostol and 69 with Foley catheter. Vaginal delivery rates were similar for controls and for patients who were induced (985.5% vs. 84.9%, not significant). Vaginal delivery rates by induction of labor type (vs. controls) were oxytocin 87.8% (P <.001), misoprostol 78.8% (P <.001) and Foley catheter 82.6% (difference not significant).

"Induction patients were more likely to become infected than augmentation patients or controls," Dr. Myles asserted. He surmised that the reason induction patients are more susceptible to infection is probably that the duration from induction to delivery is longer than from augmentation to delivery.

Dr. Myles stressed that the rates of induction of labor are rising and induction of labor is associated with chorioamnionitis, which impairs uterine contractility. Dr. Myles urges women and their physicians to avoid induction unless it is clinically indicated.

"Induction carries significant risk of infection and caesarean section and is performed too frequently. Chorioamnionitis is more likely to result in cerebral palsy, respiratory distress and hospitalization in the neonatal intensive care unit," he warned.


[Presentation title: Risks for Chorioamnionitis With Both Induction and Augmentation of Labor. Abstract p. 32S]

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