The Effect Of Pregestational BMI On Induction For Term Pregnancy

Purpose:To investigate the effectiveness,safety and effects of pregestational BMI on different induction methods for term pregnancy,so as to provide reference for the selection of induction methods for different BMI individuals in clinical practice.Methods:A retrospective analysis was made on the eligible pregnant women who had undergone antenatal examinations in The First People,s Hospital of Xiangtan City from October 2016 to January 2019,and were eventually hospitalized for delivery.Analysis of recorded data.All the data in this paper are measured accurately and continuously by the standardized operation procedure,in which the weight at 12 weeks of gestation(due to difficult to obtain accurate pregestational weight and weight changes not obviously at 12 weeks of gestation);the height measured are net values of removing shoes,Initial cervical score,6 h,12 h,24 h cervical score after induced labor treatment,duration of labor,postpartum hemorrhage,delivery mode,amniotic fluid contamination,Apgar score and neonatal asphyxia,etc,were recorded according to the final delivery results.At last,all the subjects were divided into four groups: normal group(18.5 ≤ BMI < 24),overweight group(24 ≤ BMI < 28),obesity group(BMI ≥28)and thinning group(BMI < 18).According to the delivery method adopted,the induced labor mode was set into three groups:oxytocin intravenous drip,misoprostol vaginal drug,double balloon induction of labor.According to this,we compared and analyzed the pregnancy outcomes of different pregestational BMI women treated with different methods of induced labor,so as to provide reference for different pregestational BMI population in choosing reasonable methods of induced labor.Results:1)The effects of different induced labor methods on cervical ripening in different pregestational BMI groups were double balloon induced labor > misoprostol tablet vaginal medicine > low dose oxytocin intravenous drip.There were significant differences in the effects of three induced labor methods on cervical ripening in overweight and obese BMI group.2)There are some differences in pregnancy outcomes among different methods of induced labor in different pregestational BMI groups.There are significant differences in cesarean section rates of the overweight and obese BMI groups,as follows: low dose oxytocin intravenous drip method,misoprostol tablet vaginal medication method and double balloon induction method.There was no significant difference in labor duration,postpartum hemorrhage,amniotic fluid pollution,Apgar score and neonatal asphyxia.3)In overweight and obese BMI group,there were no significant differences in labor duration,postpartum hemorrhage,amniotic fluid pollution,Apgar score and neonatal asphyxia,but there were significant differences in cesarean section rate.4)All three methods can be applied to different pregestational BMI population.Overweight and obese BMI population use double balloon induction method is relatively better,but the actual application needs to be determined according to the individual clinical situation.Conclusion:Through this study,it can be concluded that low-dose oxytocin intravenous drip method,misoprostol tablet vaginal medication method,double balloon induced labor method for full-term pregnancy in different BMI population can have a good effect on promoting cervical maturation.These induced labor methods have a certain difference in the impact of pregnancy outcomes of different BMI population.Overall,double balloon labor induction is recommended for women with pre-pregnancy BMI who are overweight or obese.In practice,considering other factors will also have an impact on the application of induced labor,so the specific choice still needs to be further evaluated in combination with clinical and patient’s personal conditions,in order to guide more scientific and reasonable choice of pregnancy health care and delivery mode,and promote the safety and health of mothers and infants.