THE EFFICIENCY AND OUTCOMES OF LABOR ACTIVATION DURING PROLONGED AND ADVANCED PREGNANCY

Objective. To evaluate the efficiency of various labor activation methods, the specific features of the course of labor, and the factors influencing the success of induction in patients with prolonged and advanced pregnancy. Subjects and methods. Seventy-one women with singleton pregnancy of 40 weeks and 2 days or more and cephalic presentation were examined. According to the method of labor induction, the women were divided into three groups: 1) amniotomy; 2) sequential use of dinoprostone and amniotomy; 3) intravenous dropwise injection of dinoprost in the presence of the whole gestational sac. Group 4 (control) comprised women with spontaneous initiation of delivery in the same gestation period. The data were statistically processed using risk ratios, odds ratio, and Wilcoxon test. Results. The efficiency of labor induction in patients who tended to have advanced pregnancy was high and amounted to 80% during labor induction via amniotomy, 86.7% via a combination of PGE 2 analogues and amniotomy, and 100% by that of dinoprost. The characteristic feature of the course of labor during advanced pregnancy is the high rate of abnormal delivery; at the same time labor induction does not increase the risk for the development of this pathology. The basic factor influencing the success of labor activation is the state of the cervix uteri; thus, labor must be induced only unless its maturation is achieved. The number of complications following induction of labor increases with the gestational period of more than 41 weeks, so the latter of 40—41 weeks is optimal for cervix uteri preparation and labor induction.

labor activation, labor induction, amniotomy, dinoprost, dinoprostone, prolonged pregnancy, advanced pregnancy