Induction of labor in women with a history of fast labor

Abstract

Objective: History of fast labor is currently subjectively defined and inductions for non-medical indications are becoming restricted. We hypothesized that women induced for a history of fast labor do not have faster previous labors and do not deliver more quickly.

Methods: A retrospective case-control cohort design studied multiparas undergoing elective induction at one high risk center. Outcomes of dyads electively induced for a history of previous fast labor indication (PFast) were compared to controls with a psychosocial indication.

Results: A total of 612 elective inductions with 1074 previous deliveries were evaluated: 81 (13%) PFast and 531 (87%) control. PFast had faster previous labors (median 5.5 h, IQR: 4.5–6) versus. control (10 h, IQR: 9–10.5; p < 0.001). Subsequent delivery time from start to expulsion was shorter for PFast (median 7 h, IQR: 5–9, p < 0.001) than controls with and without a previous labor <5.5 h (8.6 h, IQR: 6–14 and 9.5 h, IQR: 7–15, respectively). PFast were less likely to have a serious maternal complication. Neonatal complications were similar.

Conclusions: Patients induced for a history of fast labor do have faster previous labors, suggesting a significant history of fast labor can be defined as <5.5 h. These women deliver more quickly and with lower morbidity than controls when subsequently induced, therefore the benefit may warrant the risk for a select number of women with a history of a prior labor length <5.5 h.

• Elective induction
• labor duration
• labor time
• obstetrics
• precipitate labor
• rapid labor

Acknowledgements

Authors thank M. Dave Gothard, M.S. of Biostats Inc. for statistical model development and validation of results.

Declaration of interest

The authors report no declarations of interest. Authors thank the Summa Foundation for funding support.

Notes

* This work was presented at The American College of Obstetricians and Gynecologists Annual Meeting, San Diego, CA 2012.