Prediction of mode of delivery and 'DisFIL score' following induction of labor by local PGE2.

The objective of the study was to evaluate pre-induction risk factors for (i) assisted vaginal delivery (forceps or vacuum extraction), (ii) caesarean section, (iii) failed induction followed by caesarean section, and from these to evaluate a score of the 'Disadvantages Following Induction of Labour' (the DisFIL score). The study was a case-control study applied on a prospective cohort of 336 pregnant women induced by local PGE2. Assisted vaginal delivery was associated with primiparity (OR (odds ratio) = 10.7; CI, 3.6-32.0) and higher pelvic scores (Bishop score: OR = 1.9; CI, 1.4-2.6). Caesarean section was related to higher maternal age (P < 0.001) and lower pelvic scores (Bishop score: OR = 0.7; CI, 0.5-1.0, P < 0.05). When performed because of fetal distress, assisted vaginal delivery and caesarean section were both associated with lower fetal weights (P < 0.05). Failed induction followed by caesarean section was related to primiparity (P < 0.0001, Fisher's test) and lower pelvic scores (Bishop score: OR = 0.6; CI, 0.4-0.9). A higher 'DisFIL score' was associated with primiparity (OR = 4.7; CI, 2.8-8.0), higher maternal age (P < 0.01), lower pelvic scores (P < 0.01, chi 2 test) and PGE2 in intracervical gel rather than in vaginal pessaries (OR = 2.1; CI, 1.4-3.2). It is concluded that the major predictors of 'Disadvantages Following Induction of Labor' by local PGE2 are primiparity, high maternal age, low pelvic scores and the method of.