Does induction of labor for constitutionally large-for-gestational-age fetuses identified in utero reduce maternal morbidity?

Table 3 Description of obstetrical data about labor and delivery

Women with a suspected large for gestational age fetus	Overall cohort (n = 3077)% [m ± ET]	Induction of labor at 37–38 weeks^{+ 6 d}(n = 199)% [m ± ET]	Expectant management(n = 2878)% [m ± ET]	P value
Mode of delivery	(n = 3071)	(n = 199)	(n = 2872)
Spontaneous delivery	52.0	61.3	51.4	<0.0001
Overall cesareans	30.6	21.6	31.2	.005
Operative VD^a	17.4	17.1	17.4	.90
Instrumental delivery	94.2^b	96.8	94.0
Other maneuvers^c	5.8	3.2	6.0
Mode of anesthesia	(n = 2879)	(n = 194)	(n = 2685)
Spinal anesthesia	13.7	4.6	14.3	.0006
Epidural anesthesia	68.9	80.4	68.0
General anesthesia	2.1	2.6	2.1
Other	1.1	0	1.2
Duration of labor ^d	(n = 1465)	(n = 120)	(n = 1345)
< 2–6 h	39.4	45.8	38.9	.35
2 - 4 h	36.5	30.0	37.0
4 - 6 h	16.2	17.5	16.1
≥ 6–4 h	7.9	6.7	8.0
Problem during labor ^e	(n = 2910) 34.5	(n = 197) 35.5	(n = 2713) 34.4	.75
Birth weight	(n = 3077) [4012 ± 421]	(n = 199) [3792 ± 418]	(n = 2878) [4028 ± 417]	<.0001
< 3000 g	0.8	2.5	0.7	<.0001
3000 – 3499 g	9.4	21.1	8.6
3500 – 3999 g	37.0	46.8	36.3
≥ 4000 g	52.8	29.6	54.4

^aOperative VD: operative vaginal delivery.
^bInstrumental deliveries in the global cohort included: 39.1% with forceps, 11.0% with spatulas, 44.1% by vacuum extractions.
^cOther manoeuvers = maneuver for shoulders dystocia, internal cephalic version, total breech extraction, etc.
^dFrom 5 cm to full dilatation.
^eProblem during labor of any kind [fetal-pelvic disproportion, fetal heart rate anomaly, failure of induction, dynamic dystocia (hypotonic or hypertonic uterine activity or cervical dystocia), dystocia related to an abnormal position or presentation (abnormal position of the fetal head), maternal disease such as fever or hemorrhage.

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