Trends of induction of labor with success rates: Experience of a tertiary care center
- Journal
- International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics (Q1)
- Published
- 10 September 2026
- Study design
- Prospective / inception cohort
- Evidence level
- Level 2, Moderate (CEBM 2b)
- Authors
- Feras Alkharouf, Nada F Alqudaibi, Aminah A Alhamdan, Majd A Alomar, Danah I Alnahari
- PMID
- 42717831
- DOI
- 10.1002/ijgo.71295
Why clinicians should know about it
- Picked for Obstetrics and Gynecology (paper of the day, 13 September 2026): Success rates and predictors of prostaglandin E2 induction of labor
Abstract
OBJECTIVE: Induction of labor (IOL) is a common obstetric procedure performed when continuation of pregnancy poses maternal or fetal risks. Prostaglandin E2 (PGE2) is widely used for cervical ripening and induction. This study assessed the success rate of PGE2-induced labor and identified obstetric predictors of failed induction and cesarean delivery at a tertiary center in Riyadh. METHODS: This retrospective cross-sectional study included 1303 women who underwent IOL with PGE2 (tablet or pessary) at the Women's Health Hospital, National Guard Health Affairs, Riyadh, during 2023. Maternal characteristics, obstetric factors, and induction-related variables were analyzed using descriptive and inferential statistics. Logistic regression was applied to determine independent predictors of failed induction and cesarean section, with statistical significance set at P < 0.05. RESULTS: The overall success rate of PGE2 induction was 74.2%, consistent with global benchmarks. The vaginal tablet demonstrated higher effectiveness (80.6%) compared with the pessary (59.4%). Advanced maternal age, pre-eclampsia, and type 1 diabetes significantly increased the likelihood of failed induction and cesarean delivery. Intrapartum factors, particularly nonreassuring cardiotocography and inadequate cervical response, were strong determinants of cesarean section. CONCLUSION: PGE2 was effective for induction of labor in this cohort. The vaginal tablet was associated with a higher observed vaginal delivery rate than the pessary; however, this finding should be interpreted cautiously because formulation selection was not randomized and was based on availability. Individualized assessment, method selection, and fetal monitoring remain important. Women with relevant medical comorbidities should be counseled regarding their increased risk of cesarean delivery. Further prospective multicenter studies comparing efficacy, maternal safety, and neonatal outcomes are warranted.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.