Accepted Manuscript Progress of Induced Labor in Trial of Labor after Cesarean Kristina E. Sondgeroth, MD, Molly J. Stout, MD, MSCI, Anna S. Graseck, MD, MSCI, Ms Kimberly A. Roehl, MPH, George A. Macones, MD, MSCE, Alison G. Cahill, MD, MSCI PII:

S0002-9378(15)00526-8

DOI:

10.1016/j.ajog.2015.05.049

Reference:

YMOB 10432

To appear in:

American Journal of Obstetrics and Gynecology

Received Date: 6 March 2015 Revised Date:

1 May 2015

Accepted Date: 26 May 2015

Please cite this article as: Sondgeroth KE, Stout MJ, Graseck AS, Roehl KA, Macones GA, Cahill AG, Progress of Induced Labor in Trial of Labor after Cesarean, American Journal of Obstetrics and Gynecology (2015), doi: 10.1016/j.ajog.2015.05.049. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

ACCEPTED MANUSCRIPT

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Progress of Induced Labor in Trial of Labor after Cesarean

2 Kristina E. SONDGEROTH MD, Molly J. STOUT MD, MSCI,

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Anna S. GRASECK MD, MSCI, Ms. Kimberly A. ROEHL MPH,

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George A. MACONES MD, MSCE, Alison G. CAHILL MD, MSCI

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Washington University in St. Louis School of Medicine

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Department of Obstetrics and Gynecology

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Corresponding author: Kristina Epplin Sondgeroth

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Washington University in St. Louis School of Medicine

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660 South Euclid Avenue, Campus Box 8064

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St. Louis, Missouri 63110

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Phone: 314-362-1016; Fax: 314-747-1490

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Email: [email protected]

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Disclosure: The authors report no conflict of interest.

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Funding: Dr. Cahill was a Robert Wood Johnson Foundation Physician Faculty Scholar, which

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supported this work.

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Presented as a poster presentation at the 35th Annual Meeting of the Society for Maternal-Fetal

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Medicine, February 2-7, 2015, San Diego, California.

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Word count: Abstract – 275 Manuscript – 2341

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Induction of Labor after Cesarean

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CONDENSATION: Labor arrest in women undergoing induction of labor after cesarean should

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be diagnosed using the same standards for women without a prior cesarean.

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SHORT VERSION OF TITLE: Induction of Labor after Cesarean.

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Induction of Labor after Cesarean

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ABSTRACT

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OBJECTIVE: To compare the first stage of labor progress in women undergoing an induction

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of labor after cesarean to women with spontaneous labor after cesarean.

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STUDY DESIGN: We conducted a retrospective cohort study of consecutive women admitted

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for delivery with a vertex-presenting fetus who achieved vaginal delivery after cesarean. We

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compared women undergoing an induction of labor after cesarean to women with spontaneous

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labor after cesarean. Labor curves were constructed using a repeated-measures analysis, and

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interval-censored regression was used to estimate the median time spent to dilate 1 cm, stratified

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by induction status and adjusted by obesity, macrosomia, epidural, and prior vaginal delivery.

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RESULTS: Of 473 laboring women with a prior cesarean, 234 (49%) were induced. After

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adjusting for obesity, macrosomia, epidural, and prior vaginal delivery, women who underwent

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an induction had significantly longer labors than those women who presented with spontaneous

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labor. The median time to dilate from 4 cm to 10 cm took 5.6 hours (95% CI 1.8 to 18.0) in the

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induction group, and 3.2 hours (95% CI 1.0 to 10.3) in the spontaneous labor group, (p