• Daniel Oros, Raquel Garcia-Simon, Jesús Clemente, Ernesto Fabre, Manuel Angel Romero, and Antonio Montañes.
• Instituto de Investigación Sanitaria de Aragón, Obstetrics Department, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain. Electronic address: dorosl@salud.aragon.es.
• Taiwan J Obstet Gynecol. 2017 Jun 1; 56 (3): 286-290.

ObjectiveWe aimed to predict the perinatal outcomes and costs of health services following labour induction for late-term pregnancies.Materials And MethodsWe conducted a cohort study of 245 women who underwent labour induction during their 41st week of gestation. The cervical condition was assessed upon admission using the Bishop score and ultrasound cervical length measurements. We estimated the direct costs of labour induction, and a predictive model for perinatal outcomes was constructed using the decision tree analysis algorithm and a logit model.ResultsA very unfavourable Bishop score at admission (Bishop score <2) (OR, 3.43 [95% CI, 1.77-6.59]), and a history of previous caesarean section (OR, 7.72 [95% CI, 2.43-24.43]) or previous vaginal delivery (OR, 0.24 [95% CI, 0.09-0.58]) were the only variables with predictive capacity for caesarean section in our model. The mean cost of labour induction was €3465.56 (95% confidence interval [CI], 3339.53-3591.58). Unfavourable Bishop scores upon admission and no history of previous deliveries significantly increased the cost of labour induction. Both of these criteria significantly predicted the likelihood of a caesarean section in the decision tree analysis.ConclusionThe cost of labour induction mostly depends on the likelihood of successful trial of labour. Combined use of the Bishop score and previous vaginal or caesarean deliveries improves the ability to predict the likelihood of a caesarean section and the economic costs associated with labour induction for late-term pregnancies. This information is useful for patient counselling.Copyright © 2017. Published by Elsevier B.V.

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