Frederiks Femke, Lee Shalem, Dekker Gus
Women and Children's Division, Lyell McEwin Hospital, University of Adelaide, Adelaide, Australia.
J Matern Fetal Neonatal Med. 2012 Dec;25(12):2479-87. doi: 10.3109/14767058.2012.703718. Epub 2012 Jul 16.
To identify risk factors for failed induction in nulliparous women.
A retrospective cohort study of nulliparous women admitted for induction of labour (IOL). Identification of risk factors for failed IOL by comparing clinical characteristics of patients with a failed IOL defined as birth by caesarean section (LSCS) with those achieving vaginal birth.
During a 12 month episode, 400 nulliparous women had an IOL; of these 168 (42%) failed to deliver vaginally. Independent antenatal risk factors for failed IOL were higher maternal age (OR = 1.052 per additional year), being shorter (OR = 1.112 per cm less maternal height) and a lower cervical dilatation score (OR = 1.411 per lower cervical dilatation score). A longer active phase (OR = 1.004 per additional minute) was the only independent intrapartum risk factor for having a LSCS.
Maternal age, height and cervical dilatation are independent antepartum risk factors, while duration of active phase is the single independent intrapartum risk factor for a failed IOL. Increased maternal BMI was less of a risk factor than anticipated with increased risk for failed IOL, as independent risk factor, more or less restricted to the morbidly obese women.
确定初产妇引产失败的风险因素。
对因引产（IOL）入院的初产妇进行回顾性队列研究。通过比较引产失败（定义为剖宫产分娩）患者与经阴道分娩患者的临床特征，确定引产失败的风险因素。
在12个月期间，400名初产妇接受了引产；其中168例（42%）未能经阴道分娩。引产失败的独立产前风险因素包括产妇年龄较大（每增加一岁，OR = 1.052）、身材较矮（产妇身高每减少1厘米，OR = 1.112）以及宫颈扩张评分较低（宫颈扩张评分每降低一级，OR = 1.411）。活跃期较长（每增加一分钟，OR = 1.004）是剖宫产的唯一独立产时风险因素。
产妇年龄、身高和宫颈扩张是独立的产前风险因素，而活跃期时长是引产失败的唯一独立产时风险因素。产妇体重指数增加作为引产失败的独立风险因素，其风险程度低于预期，且主要局限于病态肥胖女性。
