Analysis of factors associated with failure to induce labor in delayed pregnancy
Objective To explore the factors associated with the induced labor failure in delayed pregnancy.Methods From January 2017 to January 2021,medical records of 171 postponed pregnant women who hospitalized in the Department of Obstetrics of Northwest Women's and Children's Hospital were collected.According to the results of induction of labor,they were divided into 84 cases in the group of successful induced abortion and 87 cases in the group of failed induced abortion.According to the pathological examination results of postpartum placenta,they were divided into 59 cases in subclinical chorioamnionitis group and 112 cases in non-chorioamnionitis group.The basic indicators,peripheral blood inflammatory indicators,placental pathological examination results of each group were compared,and statistical analysis was carried out.Results There were statistically significant differences in age,number of previous induced abortions,pre-pregnancy weight,pre-delivery weight,pre-pregnancy body mass index(BMI),pre-delivery BMI and neonatal birth weight between the successful and failed labor induction groups(t=-3.414,-1.220,-2.373,-2.461,-3.470,-3.764 and-5.616,respectively,P＜0.05).There was a significant difference in the height between the successful and failed induced labor groups(Z=2.158,P＜0.05).There were statistically significant differences in prenatal peripheral blood white blood cell(WBC),neutrophil percentage(NEUT),C-reactive protein(CRP)and procalcitonin(PCT)levels between the successful and failed labor induction groups(t=-2.348,-2.158,-2.614 and-2.176,respectively,P＜0.05).There were statistically significant differences in the levels of WBC,NEUT,CRP and PCT in peripheral blood between subclinical chorioamnionitis group and the non-chorioamnionitis group(t=2.589,2.603,2.615 and 2.144,respectively,P＜0.05).There was statistically significant difference in the incidence of subclinical chorioamniotitis in postpartum placenta between the successful and failed labor induction groups(X2=75.385,P＜0.001).There was also a statistically significant difference in the incidence of postpartum fever between the successful and failed labor induction groups(Fisher's exact test,P=0.001).Multivariate Logistic regression analysis showed that maternal age(OR=1.203,95％CI:1.019-1.419),height(OR=1.151,95％CI:1.021-2.060),number of induced abortions(OR=2.021,95％CI:1.571-4.216),pre-delivery BMI(OR=3.403,95％CI:2.581-5.348),WBC(OR=1.021,95％CI:1.001-1.046),and newborn birth weight(OR=1.003,95％CI:1.001-1.004)were all risk factors for induced labor failure(P＜0.05).The ROC curve analysis showed that the cut-off values of WBC,NEUT,CRP and PCT in the diagnosis of subclinical chorioamnionitis were 7.85 X 109/L,76.00％,14.00μg/mL and 0.04ng/mL,respectively.The AUC of WBC+NEUT+CRP+PCT in the joint diagnosis of subclinical chorioamnitis was 0.683,and the sensitivity was 85.40％,and the specificity was 77.90％.The combination of the four indexes in the diagnosis of subclinical chorioamnitis had higher AUC,sensitivity and specificity,which was superior to the diagnosis of single indexes.Conclusion Maternal age,height,number of induced abortions,pre-delivery BMI,WBC and neonatal birth weight are all risk factors for induced labor failure.Subclinical chorioamnionitis is one of the high-risk factors for induced labor failure.
万方数据
维普
