Maternal and perinatal outcome of induction at 39 weeks versus expectant management in labor after cesarean section.

Objective: To study induction of labor (IOL) at 39 weeks compared with expectant management among women undergoing labor after cesarean section (LAC) with no prior vaginal delivery. Methods: A retrospective cohort study including all women undergoing LAC with no prior vaginal delivery, between March 2011 and January 2021. We allocated the study cohort into two groups: IOL at 390/7 to 396/7 and all LACs at ≥400/7 weeks of gestation. The primary outcome was a composite of adverse neonatal outcome. The secondary outcome was a composite of adverse maternal outcome. Results: Overall, 1022 women met inclusion criteria, of whom 89 (8.7%) had IOL at 390/7–396/7 weeks and 933 (91.3%) had LAC at ≥400/7 weeks. The composite neonatal outcome rate was comparable between groups (0.186). There were three uterine ruptures (3.4%) in the IOL group and 11 (1.2%) in the LAC at ≥40 weeks group (P = 0.115). The rate of the composite maternal outcomes occurrence was higher in the IOL group (18.0% vs. 10.1%, P = 0.022). Conclusion: IOL at 39 weeks among women undergoing LAC with no prior vaginal delivery is not associated with improved neonatal outcomes when compared with expectant management but may be associated with a higher rate of adverse maternal outcomes. SynopsisThe contents of this page will be used as part of issue TOC only. It will not be published as part of main article. Induction of labor after cesarean section without prior vaginal delivery at 39 weeks does not compromise neonatal outcomes but increases adverse maternal outcomes rate. [ABSTRACT FROM AUTHOR]