Induction of labor in women that had a previous cesarean delivery.

OBJECTIVE: This study aims to evaluate factors that predict the likelihood of the success of induction of labor (IOL) in women that had a previous cesarean section (pCS).

METHODS: Pregnant women with one pCS performed more than 18 months prior were included in this retrospective observational study. Of the 242 eligible women, 234 were enrolled; 120 (51.3%) of these women delivered vaginally (VD), with the remainder receiving a repeat CS.

RESULTS: The main reasons for IOL were premature rupture of membranes (PROM) (37.1%) and post-date pregnancy (26.5%). Babies with a birth weight≥4000 g were more prevalent in women undergoing CS (21/114; 18.4%, p<0.02) and were associated with the failure of IOL. Uterine rupture during labor (1.3%) occurred in three cases. Having had a previous vaginal delivery (VD) (p=0.01), not being African (p=0.022), and receiving IOL for PROM (p=0.04) with a cervical Bishop score≥5 (p=0.015) significantly predicted the occurrence of a VD, with an 15% variance (p<0.001). An age>35 years appears to not affect the success of induction.

CONCLUSIONS: A successful IOL should be expected in Caucasian women induced for PROM with a favorable Bishop score.