Induction of labor in obese women

Research Article


Abstract views: 164 / PDF downloads: 80

Authors

  • Salvatore Felis

DOI:

https://doi.org/10.58372/2835-6276.1075

Keywords:

labor in obese women

Abstract

People with obesity may require induction of labour (IoL) due to a higher incidence of pre-existing comorbidities and pregnancy complications, as well as to prevent post-term pregnancies and late-term stillbirths. IoL at 39 e 40 weeks is associated with fewer caesarean births and lower morbidity for the pregnant person and neonate when compared with expectant management. Ensuring the success and safety of IoL in people with obesity requires adherence to evidence-based protocols for the management of labour induction and augmentation. Cervical ripening as well as the latent and active phases of labour in people with obesity may be considerably prolonged, requiring higher cumulative doses of oxytocin. This should be guided by intrauterine pressure catheters and early provision of neuraxial analgesia, where possible. There is insufficient evidence to recommend one method of IoL over another. The need for higher doses of prostaglandins and concurrent agents for cervical ripening should be studied in prospective studies.

References

Whitlock G, Lewington S, Sherliker P, Clarke R, Emberson J, Halsey J, et al. Prospective Studies Collaboration Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies. Lancet 2009; 373(9669):1083-96.

Hales MD Craig M, Carroll M.S.P.H Margaret D, Fryar M.S.P.H Cheryl D, Ogden Ph.D Cynthia L. Prevalence of obesity and severe obesity among adults: United States, 2017e2018. Published, https://www.cdc.gov/nchs/products/databriefs/db360. htm. [Accessed 23 April 2021].

Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based measurement studies with 19$2 million participants. Lancet 2016;387(10026):1377-96.

WHO Consultation on Obesity. Obesity: preventing and managing the global epidemic. Report of aWHO consultation, vol. 894. Geneva, Switzerland: World Health Organization; 2000. p. 1-253.

Wharton S, Lau DCW, Vallis M, Sharma AM, Biertho L, Campbell-Scherer D, et al. Obesity in adults: a clinical practice guideline. Can Med Assoc J 2020;192(31): E875-91.

Sharma AM, Kushner RF. A proposed clinical staging system for obesity. Int J Obes 2009;33(3):289-95.

Padwal RS, Pajewski NM, Allison DB, Sharma AM. Using the Edmonton obesity staging system to predict mortality in a population-representative cohort of people with overweight and obesity. Can Med Assoc J 2011;183(14): E1059.

Canning KL, Brown RE, Wharton S, Sharma AM, Kuk JL. Edmonton obesity staging system prevalence and association with weight loss in a publicly funded referral-based obesity clinic. J Obes 2015; 2015:619734.

Wolfe KB, Rossi RA,Warshak CR. The effect of maternal obesity on the rate of failed induction of labor. Am J Obstet Gynecol 2011;205(2):128. e121-127.

Arrowsmith S, Wray S, Quenby S. Maternal obesity and labour complications following induction of labour in prolonged pregnancy. BJOG: Int J Obstet 2011;118(5):578-88.

El-Chaar D, Finkelstein SA, Tu X, Fell DB, Gaudet L, Sylvain J, et al. The impact of increasing obesity class on obstetrical outcomes. J Obstet Gynaecol Can 2013;35(3):224-33.

Polonia Valente R, Santos P, Ferraz T, Montenegro N, Rodrigues T. Effect of obesity on labor duration among nulliparous women with epidural analgesia. J Matern Fetal Neonatal Med 2020;33(13):2195-201.

McCall SJ, Li Z, Kurinczuk JJ, Sullivan E, Knight M. Maternal and perinatal outcomes in pregnant women with BMI >50: an international collaborative study. PLoS One 2019;14(2). e0211278-e0211278.

Calderon AC, Quintana SM, Marcolin AC, Berezowski AT, Brito LG, Duarte G, et al. Obesity and pregnancy: a transversal study from a low-risk maternity. BMC Pregnancy Childbirth 2014; 14:249.

Middleton P, Shepherd E, Morris J, Crowther CA, Gomersall JC. Induction of labour at or beyond 37 weeks' gestation. Cochrane Database Syst Rev 2020;7. CD004945.

National Institute for Health and Clinical Excellence. Inducing labour (NG207). Published 2021, https://www.nice.org.uk/ guidance/ng207. [Accessed 7 November 2021].

American College of Obstetricians and Gynecologists. Practice bulletin no. 146: management of late-term and postterm pregnancies. Obstet Gynecol 2014;124(2 Pt 1):390-6.

Delaney M, Roggensack A. No. 214-Guidelines for the management of pregnancy at 41þ0 to 42þ0 weeks. J Obstet Gynaecol Can 2017;39(8): e164-74.

Hermesch AC, Allshouse AA, Heyborne KD. Body mass index and the spontaneous onset of parturition. Obstet Gynecol 2016;128(5):1033-8.

Denison F, Price J, Graham C, Wild S, Liston W. Maternal obesity, length of gestation, risk of postdates pregnancy and spontaneous onset of labour at term. BJOG An Int J Obstet Gynaecol 2008;115(6):720-5.

Frolova AI,Wang JJ, Conner SN, Tuuli MG, Macones GA,Woolfolk CL, et al. Spontaneous labor onset and outcomes in obese women at term. Am J Perinatol 2018;35(1):59-64.

Kerbage Y, Senat MV, Drumez E, Subtil D, Vayssiere C, Deruelle P. Risk factors for failed induction of labor among pregnant women with Class III obesity. Acta Obstet Gynecol Scand 2020;99(5):637-43.

Carlson NS, Hernandez TL, Hurt KJ. Parturition dysfunction in obesity: time to target the pathobiology. Reprod Biol Endocrinol 2015; 13:135.

Stirrat LI, O’Reilly JR, Barr SM, Andrew R, Riley SC, Howie AF, et al. Decreased maternal hypothalamic-pituitary-adrenal axis activity in very severely obese pregnancy: associations with birthweight and gestation at delivery. Psychoneuroendocrinology 2016; 63:135-43.

Smith R, Mesiano S, McGrath S. Hormone trajectories leading to human birth. Regul Pept 2002;108(2):159-64.

D'Souza R, Horyn I, Pavalagantharajah S, Zaffar N, Jacob CE. Maternal body mass index and pregnancy outcomes: a systematic review and metaanalysis. Am J Obstet Gynecol MFM. 2019;1(4):100041.

Higgins L, Greenwood SL, Wareing M, Sibley CP, Mills TA. Obesity and the placenta: a consideration of nutrient exchange mechanisms in relation to aberrant fetal growth. Placenta 2011;32(1):1-7.

O'Dwyer V, O'Kelly S, Monaghan B, Rowan A, Farah N, Turner MJ. Maternal obesity and induction of labor. Acta Obstet Gynecol Scand 2013;92(12):1414-8.

Little J, Nugent R, Vangaveti V. Influence of maternal obesity on Bishop Score and failed induction of labour: a retrospective cohort study in a regional tertiary centre. Aust N Z J Obstet Gynaecol 2019;59(2):243-50.

Radulescu L, Munteanu O, Popa F, Cirstoiu M. The implications and consequences of maternal obesity on fetal intrauterine growth restriction. J Med Life. 2013;6(3):292-8.

Tanner LD, Brock Chauhan SP. Severity of fetal growth restriction stratified according to maternal obesity. J Matern Fetal Neonatal Med : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstet. 2020:1-5.

Yao R, Park BY, Caughey AB. The effects of maternal obesity on perinatal outcomes among those born small for gestational age. J Matern Fetal Neonatal Med 2017;30(12):1417-22. The official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstet.

Yao R, Ananth CV, Park BY, Pereira L, Plante LA, Perinatal Research C. Obesity and the risk of stillbirth: a population-based cohort study. Am J Obstet Gynecol 2014;210(5): e451-9. 457.

Gibbs Pickens CM, Kramer MR, Howards PP, Badell ML, Caughey AB, Hogue CJ. Term elective induction of labor and pregnancy outcomes among obese women and their offspring. Obstet Gynecol 2018;131(1):12-22.

Kawakita T, Iqbal SN, Huang CC, Reddy UM. Nonmedically indicated induction in morbidly obese women is not associated with an increased risk of cesarean delivery. Am J Obstet Gynecol 2017; 217:451. e1-8.

Palatnik A, Kominiarek MA. Outcomes of elective induction of labor versus expectant management among obese women at >39 weeks. Am J Perinatol 2020;37(7):695-707.

Eberle A, Czuzoj-Shulman N, Azoulay L, Abenhaim HA. Induction of labor at 39 weeks and risk of cesarean delivery among obese women: a retrospective propensity score matched study. J Perinat Med 2021;49(7):791-6.

Nugent R, Costa C, Vangaveti V. Caesarean risk in obese women at term: a retrospective cohort analysis. Aust N Z J Obstet Gynaecol 2017;57(4):440-5.

D'Souza R, Horyn I, Jacob CE, Zaffar N, Horn D, Maxwell C. Birth outcomes in women with body mass index of 40 kg/m (2) or greater stratified by planned and actual mode of birth: a systematic review and meta-analysis. Acta Obstet Gynecol Scand 2021;100(2):200-9.

Subramaniam A, Corvey KJ, Kilgore ML, Edwards RK. Planned cesarean delivery compared to induction of labor in women with class III obesity: a cost-minimization analysis. J Matern Fetal Neonatal Med 2016;29(19):3084-8.

Tzadikevitch-Geffen K, Melamed N, Aviram A, Sprague AE, Maxwell C, Barrett J, et al. Neonatal outcome by planned mode of delivery in women with a body mass index of 35 or more: a retrospective cohort study. BJOG An Int J Obstet Gynaecol 2021;128(5):900-6.

Paidas Teefey C, Reforma L, Koelper NC, Sammel MD, Srinivas SK, Levine LD, et al. Risk factors associated with cesarean delivery after induction of labor in women with class III obesity. Obstet Gynecol 2020;135(3):542-9.

Hopkins MK, Grotegut CA, Swamy GK, Myers ER, Havrilesky LJ. Induction of labor versus scheduled cesarean in morbidly obese women: a cost-effectiveness analysis. Am J Perinatol 2019;36(4):399-405.

Rossi RM, Requarth EW, Warshak CR, Dufendach K, Hall ES, DeFranco EA. Predictive model for failed induction of labor among obese women. Obstet Gynecol 2019;134(3):485-93.

Maged AM, El-Semary AM, Marie HM, Belal DS, Hany A, Taymour MA, et al. Effect of maternal obesity on labor induction in postdate pregnancy. Arch Gynecol Obstet 2018;298(1):45-50.

Pevzner L, Powers BL, Rayburn WF, Rumney P, Wing DA. Effects of maternal obesity on duration and outcomes of prostaglandin cervical ripening and labor induction. Obstet Gynecol 2009;114(6):1315-21.

Ronzoni S, Rosen H, Melamed N, Porat S, Farine D, Maxwell C. Maternal obesity class as a predictor of induction failure: a practical risk assessment tool. Am J Perinatol 2015;32(14):1298-304.

Gauthier T, Mazeau S, Dalmay F, Eyraud JL, Catalan C, Marin B, et al. Obesity and cervical ripening failure risk. J Matern Fetal Neonatal Med 2012;25(3):304e7. The official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstet.

Ellis JA, Brown CM, Barger B, Carlson NS. Influence of maternal obesity on labor induction: a systematic review and metaanalysis. J Midwifery Wom Health 2019;64(1):55-67.

Carpenter JR. Intrapartum management of the obese gravida. Clin Obstet Gynecol 2016;59(1):172-9.

Sarumi MA, Gherman RB, Bell TD, Jairath P, Johnson MJ, Burgess AL. A comparison of cervical ripening modalities among overweight and obese nulliparous gravidas. J Matern Fetal Neonatal Med 2020;33(22):3804-8.

Beckwith L, Magner K, Kritzer S, Warshak CR. Prostaglandin versus mechanical dilation and the effect of maternal obesity on failure to achieve active labor: a cohort study. J Matern Fetal Neonatal Med 2017;30(13):1621-6.

Suidan RS, Rondon KC, Apuzzio JJ, Williams SF. Labor outcomes of obese patients undergoing induction of labor with misoprostol compared to dinoprostone. Am J Perinatol 2015;32(2):187-92.

Shahabuddin Y, Murphy DJ. Cervical ripening and labour induction: a critical review of the available methods. Best Pract Res Clin Obstet Gynaecol 2022; 79:3-17. https://doi.org/10.1016/j.bpobgyn.2021.11.008.

Meier K, Parrish J, D'Souza R. Prediction models for determining the success of labor induction: a systematic review. Acta Obstet Gynecol Scand 2019;98(9):1100-12.

Alavifard S, Meier K, Shulman Y, Tomlinson G, D'Souza R. Derivation and validation of a model predicting the likelihood of vaginal birth following labour induction. BMC Pregnancy Childbirth 2019;19(1):130.

Gunatilake RP, Smrtka MP, Harris B, Kraus DM, Small MJ, Grotegut CA, et al. Predictors of failed trial of labor among women with an extremely obese body mass index. Am J Obstet Gynecol 2013;209(6):562. e561-562.e565.

Borghesi Y, Labreuche J, Duhamel A, Pigeyre M, Deruelle P. Risk of cesarean delivery among pregnant women with class III obesity. Int J Gynecol Obstet 2017;136(2):168-74.

Dammer U, Bogner R, Weiss C, Faschingbauer F, Pretscher J, Beckmann MW, et al. Influence of body mass index on induction of labor: a historical cohort study. J Obstet Gynaecol Res 2018;44(4):697-707.

Zelig CM, Nichols SF, Dolinsky BM, Hecht MW, Napolitano PG. Interaction between maternal obesity and Bishop score in predicting successful induction of labor in term, nulliparous patients. Am J Perinatol 2013;30(1):75-80.

D'Souza R, Ashraf R, Foroutan F. Predictions models for determining the success of labour induction: an updated systematic review and critical analysis. Best Pract Res Clin Obstet Gynaecol 2022; 79:42-54.

Soni S, Chivan N, Cohen WR. Effect of maternal body mass index on oxytocin treatment for arrest of dilatation. J Perinat Med 2013;41(5):517-21.

Maeder AB, Vonderheid SC, Park CG, Bell AF, McFarlin BL, Vincent C, et al. Titration of intravenous oxytocin infusion for postdates induction of labor across body mass index groups. J Obstet Gynecol Neonatal Nurs 2017;46(4):494-507.

Stefely E, Warshak CR. Contraction frequency after administration of misoprostol in obese versus nonobese women. J Matern Fetal Neonatal Med 2019;32(21):3526-30.

Hill M, Reed KL, Cohen WR. Oxytocin utilization for labor induction in obese and lean women. J Perinat Med 2015;43(6): 703-6.

Nuthalapaty FS, Rouse DJ, Owen J. The association of maternal weight with cesarean risk, labor duration, and cervical dilation rate during labor induction. Obstet Gynecol 2004;103(3):452-6.

Roman H, Goffinet F, Hulsey TF, Newman R, Robillard PY, Hulsey TC. Maternal body mass index at delivery and risk of caesarean due to dystocia in low risk pregnancies. Acta Obstet Gynecol Scand 2008;87(2):163-70.

Vahratian A, Zhang J, Troendle JF, Savitz DA, Siega-Riz AM. Maternal prepregnancy overweight and obesity and the pattern of labor progression in term nulliparous women. Obstet Gynecol 2004;104(5 Pt 1):943-51.

Kominiarek MA, Zhang J, Vanveldhuisen P, Troendle J, Beaver J, Hibbard JU. Contemporary labor patterns: the impact of maternal body mass index. Am J Obstet Gynecol 2011;205(3):244. e241-248.

Lassiter JR, Holliday N, Lewis DF, Mulekar M, Abshire J, Brocato B. Induction of labor with an unfavorable cervix: how does BMI affect success? (z). J Matern Fetal Neonatal Med 2016;29(18):3000-2. the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstet.

Kobayashi N, Lim BH. Induction of labour and intrapartum care in obese women. Best Pract Res Clin Obstet Gynaecol 2015; 29(3):394-405.

Roloff K, Peng S, Sanchez-Ramos L, Valenzuela GJ. Cumulative oxytocin dose during induction of labor according to maternal body mass index. Int J Gynecol Obstet 2015;131(1):54-8.

Adams AD, Coviello EM, Drassinower D. The effect of maternal obesity on oxytocin requirements to achieve vaginal delivery. Am J Perinatol 2020;37(4):349-56.

Garabedian MJ, Hansen WF, McCord LA, Manning MA, O'Brien JM, Curry Jr TE. Up-regulation of oxytocin receptor expression at term is related to maternal body mass index. Am J Perinatol 2013;30(6):491-7.

Zhang J, Bricker L, Wray S, Quenby S. Poor uterine contractility in obese women. BJOG An Int J Obstet Gynaecol 2007; 114(3):343-8.

Wuntakal R, Kaler M, Hollingworth T. Women with high BMI: should they be managed differently due to antagonising action of leptin in labour? Med Hypotheses 2013;80(6):767-8.

Grotegut CA, Gunatilake RP, Feng L, Heine RP, Murtha AP. The influence of maternal body mass index on myometrial oxytocin receptor expression in pregnancy. Reprod Sci 2013;20(12):1471-7.

Banner H, D'Souza R. Towards an evidence-based approach to optimize the success of labour induction. Best Pract Res Clin Obstet Gynaecol 2021; 77:129-43.

Practice Guidelines for Obstetric Anesthesia. An updated report by the American society of anesthesiologists task force on obstetric anesthesia and the society for obstetric anesthesia and perinatology. Anesthesiology 2016;124(2):270-300.

Warner LL, Arendt KW, Theiler RN, Sharpe EE. Analgesic considerations for induction of labor. Best Pract Res Clin Obstet Gynaecol 2021; 77:76-89.

Tonidandel A, Booth J, D'Angelo R, Harris L, Tonidandel S. Anesthetic and obstetric outcomes in morbidly obese parturients: a 20-year follow-up retrospective cohort study. Int J Obstet Anesth 2014;23(4):357-64.

Downloads

Published

2023-09-15

How to Cite

Salvatore Felis. (2023). Induction of labor in obese women: Research Article. American Journal of Medical and Clinical Research & Reviews, 2(9), 1–14. https://doi.org/10.58372/2835-6276.1075

Issue

Section

Articles