Parity and gravidity have been shown to be associated with hypertension and changes in blood pressure, but results are conflicting. We aimed to estimate the association between gravidity and parity with hypertension and blood pressure. A systematic search of multiple databases was performed. Studies were included if they reported on parity or gravidity and hypertension or blood pressure. Study characteristics were extracted and estimates were pooled using random-effects meta-analysis. A meta-analysis of 18 studies demonstrated that parity was associated with greater odds of hypertension (pooled OR = 1.31;95%CI:1.14,1.50;I2 = 90.4%) when compared to nulliparity. There was no significant difference in odds of hypertension at a parity of 1 or 2; at a parity of 3 and 4, odds of hypertension were significantly higher when compared to nulliparity. Results suggest that parity is associated with hypertension risk in a graded manner, however, there was high heterogeneity. The mechanism remains unknown but is likely multifactorial.

Objective To evaluate the effectiveness of telerehabilitation-delivered pelvic floor muscle training (PFMT) for women with stress urinary incontinence (SUI), focusing on clinical outcomes, adherence, satisfaction, and healthcare accessibility. Data Sources A systematic search was conducted across four electronic databases: Embase, Scopus, CINAHL, and MEDLINE, in June 2024 and updated in May 2026. Study Selection Eligible studies were randomised controlled trials (RCTs) examining PFMT delivered via virtual platforms (e.g., mobile applications, video conferencing, or internet-based programs) for women (≥18 years) with SUI. A total of 13 RCTs met all inclusion criteria. Data Extraction Two independent reviewers extracted data regarding study characteristics, clinical outcomes, and implementation metrics (adherence and satisfaction). Methodological quality was assessed using the Cochrane Risk of Bias 2 (RoB 2) tool. Data Synthesis Due to substantial methodological and clinical heterogeneity, findings were synthesized narratively using the Synthesis Without Meta-analysis (SWiM) reporting guidelines. Digital interventions consistently produced significant subjective reductions in SUI symptoms and improvements in condition-specific quality of life (QoL). Telerehabilitation often demonstrated superior clinical outcomes and higher adherence compared to passive management or no-treatment controls. When compared to active conventional care, such as face-to-face physiotherapy or paper booklets, digital tools generally showed comparable rather than superior efficacy. Adherence was a primary mechanism for success, though technological complexity was a barrier in some protocols. Interventions were safe, with no serious adverse events reported. Conclusions Telerehabilitation-delivered PFMT has potential as a safe, feasible, and effective modality for managing SUI. It offers a robust, scalable alternative to traditional care, particularly by improving accessibility for women facing geographical or logistical barriers.

BACKGROUND:Pelvic health conditions significantly impact quality of life and are prevalent in the general population. Urinary and fecal incontinence, pelvic organ prolapse, and pelvic pain are examples of pelvic health conditions. A scoping review was conducted to understand what is currently known about pelvic health conditions experienced by Indigenous populations worldwide. To date, no such review has been reported. METHODS:A scoping review methodology was used. In February 2024, a search was conducted, capturing both primary and grey literature. An iterative process of abstract and full text screening was conducted by two reviewers before proceeding to data extraction. Inclusion criteria focused on English publications and reports of pelvic health conditions experienced by Indigenous peoples. Data was collected in Google Sheets, and then underwent descriptive statistical analysis. Publications that provided qualitative data were further analyzed using thematic analysis. RESULTS:A total of 242 publications were included in the analysis. Several patterns emerged: most publications originated from English-speaking regions, fewer than half of publications specifically recruited Indigenous peoples, women participated in more studies than men, and bladder conditions were most frequently reported. Perceptions of pelvic health conditions and experiences with help seeking and the health care system were described. Notable gaps were a lack of publications and representation of Indigenous peoples from China, Russia, and Nordic countries, minimal representation of gender diverse populations, few publications reporting on auto-immune and bowel conditions, and limited mention of trauma-informed and culturally safe approaches. CONCLUSIONS:This study highlights gaps in the current literature around gender representation, bowel and auto-immune conditions, regional representation, and the use of safety frameworks, which may inform future research initiatives. It also summarizes the existing literature, which may inform clinical and health system-level decision making.

Introduction Cardiovascular disease is the leading cause of death among women worldwide, and hypertension is one of the most prevalent and modifiable risk factors. Parity and gravidity, independent of pregnancy complications, have each been associated with hypertension, although results are conflicting. Therefore, we propose to estimate the association between parity and gravidity with hypertension and blood pressure in a systematic review of the literature.Methods and analysis A systematic review will be conducted to estimate the association between parity and gravidity and hypertension and blood pressure. Electronic databases (Excerpta Medica Database, Ovid MEDLINE, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature Plus and Web of Science) will be searched from inception to January 2025. Two investigators will independently screen identified abstracts and select observational cohort studies, case-control studies and randomised controlled trials examining parity or gravidity and hypertension or blood pressure. Extracted data will include study and population characteristics, comorbidities, parity, gravidity, incidence of hypertension and changes in blood pressure, study quality and risk of bias. If there are sufficient data, they will be summarised using random effects meta-analysis to estimate the pooled risk ratio or odds ratio of hypertension. Stratified and subgroup analyses will be used to explore potential sources of heterogeneity.PROSPERO registration number CRD42024560535.

A 38-year-old woman presented to the emergency department with sudden onset voiding dysfunction, vaginal pain and a new protruding vaginal mass following a sneezing episode.Her presenting creatinine was normal at 79 and GFR was 82.She has a past medical history of mild stress urinary incontinence, non-specified anxiety, and depression disorders on escitalopram daily, and has had two uncomplicated vaginal deliveries.Urogynecology was consulted for an irreducible vaginal prolapse as multiple attempts to reduce the bulge were unsuccessful.On examination, a purple mass was noted at the 6-o'clock position beneath the urethral meatus (Figure 1A).This appeared to be most in keeping with a thrombosed lesion.The patient was in significant pain. Diagnostic processTwo urogynecology staff examined the patient in the clinic.A Foley catheter was inserted, and urine sent for culture.Local anesthetic jelly was applied, and with patient consent the mass was drained of clots and serosanguinous fluid via a small scalpel incision.Monsel's solution was applied for hemostasis.The patient experienced immediate relief.The fluid was sent for culture and cytology.She was started empirically on Amoxicillin-Clavulanic Acid 875/125 mg as she KEY MESSAGES• A vaginal bulge is not always pelvic organ prolapse.• A periurethral mass may be a prolapsed bladder lesion or urethral leiomyoma.• Examine the mass to its base to identify its origin: this may require imaging or cystoscopy CUAJ -Resident's Room Le Gallee et al Case series -Ureterocele prolapse and urethral myoma 2

INTRODUCTION:Vaginal surgery has a superior outcome profile compared with other surgical routes, yet skills are declining because of low case volumes. Graduating residents' confidence and preparedness for vaginal surgery has plummeted in the past decade. The objective of the present study was to investigate whether procedure-specific simulation skills, vs usual training, result in improved operative competence. MATERIAL AND METHODS:We completed a randomized controlled trial of didactic and procedural training via low fidelity vaginal surgery models for anterior repair, posterior repair (PR), vaginal hysterectomy (VH), recruiting novice gynecology residents at three academic centers. We evaluated performance via global rating scale (GRS) in the real operating room and for corresponding procedures by attending surgeon blinded to group. Prespecified secondary outcomes included procedural steps knowledge, overall performance, satisfaction, self-confidence and intraoperative parameters. A priori sample size estimated 50 residents (20% absolute difference in GRS score, 25% SD, 80% power, alpha 0.05). CLINICALTRIALS:gov: Registration no. NCT05887570. RESULTS:We randomized 83 residents to intervention or control and 55 completed the trial (2011-23). Baseline characteristics were similar, except for more fourth-year control residents. After adjustment of confounders (age, level, baseline knowledge), GRS scores showed significant differences overall (mean difference 8.2; 95% confidence interval [CI]: 0.2-16.1; p = 0.044) and for VH (mean difference 12.0; 95% CI: 1.8-22.3; p = 0.02). The intervention group had significantly higher procedural steps knowledge and self-confidence for VH and/or PR (p < 0.05, adjusted analysis). Estimated blood loss, operative time and complications were similar between groups. CONCLUSIONS:Compared to usual training, procedure-specific didactic and low fidelity simulation modules for vaginal surgery resulted in significant improvements in operative performance and several other skill parameters.

OBJECTIVE: To investigate whether procedure-specific skills acquired in a surgical lab, versus usual training, result in improved operative competence. DESIGN: randomised controlled trial. Didactic and procedural training occurred using three low fidelity vaginal surgery models: anterior repair (AR), posterior repair (PR), vaginal hysterectomy (VH). POPULATION/SETTING: Junior gynaecology residents at three academic centres. METHODS: The primary outcome was performance evaluated by attending staff blinded to group, via global rating scale (GRS) in the real operating room and for corresponding procedures. Prespecified secondary outcomes included procedural steps knowledge, overall performance impression, resident satisfaction, self-confidence and intraoperative parameters. A priori sample size estimated 50 residents (20% absolute difference in GRS score, 25% SD, 80% power, alpha 0.05). RESULTS: 83 residents were randomised to intervention or control and 55 completed the trial (2012-22). All characteristics were similar between groups. Adjusted GRS scores (by age, level and baseline knowledge) showed a significant group difference overall (mean difference 8.2; 95% CI 0.2,16.1; p=0.044) and for VH (mean difference 12.0; 95% CI 1.8, 22.3; p=0.02), but not for AR or PR. The intervention group also had significantly higher procedural steps knowledge, satisfaction and self-confidence for VH and PR (p<0.05 for all). Estimated blood loss, operative time and complications were similar between groups. CONCLUSIONS: Compared to usual training, surgical education modules using procedure-specific low fidelity models for vaginal surgery resulted in significant improvements in actual operative performance and several other skill parameters. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, [www.clinicaltrials.gov](http://www.clinicaltrials.gov), NCT05887570

Pelvic floor disorders (PFD) have a detrimental effect on quality of life. Despite the available treatments, women often do not seek medical care. Patient knowledge has been identified as a major barrier to accessing care. The objective of this study was to assess knowledge on PFD amongst women in Edmonton, hypothesizing that immigrant women are less knowledgeable about PFD than Canadian-born women. A cross-sectional study of immigrant women and Canadian-born women was conducted. Immigrant women were recruited at the Multi-Cultural Health Brokers Co-op (MCHB) and Canadian-born women at a colposcopy clinic. The Prolapse and Incontinence Knowledge Questionnaire (PIKQ) was administered. Scores for UI and POP were calculated and compared using a Mann–Whitney U test and a t test. A subgroup analysis of immigrants was carried out according to length of stay in Canada and ethnicity. Ethics approval was obtained from the University of Alberta Human Research Ethics Office. A total of 106 immigrants and 102 Canadian-born women completed the PIKQ. The overall PIKQ scores were 12.7 for immigrant women and 14.4 for Canadian-born women (p = 0.04). Immigrant women who had lived in Canada for >10 years had higher scores (mean = 13.2) compared with women with less than 10 years in Canada (mean = 11.8). Women from South Asia had higher overall PIKQ scores (mean = 14.6) whereas women from sub-Saharan Africa had the lowest scores (mean = 12.1). Immigrant women in Edmonton were found to have less knowledge on PFD than Canadian-born women.

ObjectifPasser en revue l'utilisation, l'entretien et l'ajustement des pessaires.Population cibleLes femmes qui ont besoin d'utiliser un pessaire en raison d'un prolapsus génital et/ou d'une incontinence urinaire d'effort. L'utilisation peut être indiquée chez les femmes enceintes dans certains scénarios cliniques liés à la grossesse, dont l'incarcération utérine et le risque de travail préterme liée à l'incompétence du col.OptionsLes pessaires constituent une option pour les femmes atteintes d'un prolapsus et/ou d'une incontinence urinaire d'effort. De plus, certains types de pessaires peuvent être utilisés chez des patientes atteintes d'incompétence du col ou d'une incarcération utérine.IssuesIl est possible de trouver un pessaire efficace chez la plupart des femmes atteintes d'un prolapsus génital ou d'une incontinence urinaire d'effort de façon à obtenir un excellent soulagement des symptômes, un taux de satisfaction élevé et des complications minimes.Bénéfices, risques et coûtsLes femmes atteintes d'un prolapsus génital et/ou d'une incontinence urinaire d'effort peuvent choisir d'utiliser un pessaire pour traiter leurs symptômes au lieu de subir une intervention chirurgicale ou dans l'attente d'une telle intervention. Des complications majeures ont été observées seulement en cas de soins de pessaire négligés. Les complications mineures (telles que les pertes vaginales, les odeurs et les érosions) sont généralement traitables avec succès.Données probantesDes recherches ont été effectuées dans la base de données Medline afin de récupérer les articles pertinents publiés jusqu'en décembre 2018. Le présent document constitue une mise à jour de la mise à jour technique de la SOGC publiée en 2013, laquelle a été la première directive clinique publiée à l'international relativement à l'utilisation des pessaires. Une ligne directrice australienne sur l'utilisation des pessaires pour le traitement du prolapsus a été publiée plus tard en 2013.Méthodes de validationLes auteures ont évalué la qualité des données probantes et la solidité des recommandations au moyen des critères du cadre méthodologique du Groupe d’étude canadien sur les soins de santé préventifs (annexe A).Professionnels concernésGynécologues, obstétriciens, médecins de famille, physiothérapeutes, résidents et moniteurs cliniques (fellows).DÉCLARATIONS SOMMAIRES1Il est possible de trouver un pessaire efficace chez la plupart des femmes atteintes d'un prolapsus génital ou d'une incontinence urinaire d'effort pour le traitement de leurs symptômes (II-2).2Le taux de satisfaction chez les femmes qui utilisent un pessaire est très élevé (I).3Certains pessaires peuvent prévenir une récidive d'incarcération utérine (III).4Le rôle des pessaires spécifiquement conçus pour prévenir le travail préterme n'est pas clair (I).5Les complications associées à l'utilisation d'un pessaire sont généralement mineures, les pertes vaginales étant le problème le plus fréquent (II-3).6Il est possible de traiter l’érosion vaginale par le retrait du pessaire et une œstrogénothérapie vaginale optionnelle (II-2).RECOMMANDATION1Il y a lieu d'envisager l'utilisation d'un pessaire chez toute femme éprouvant des symptômes incommodants dus à un prolapsus génital et/ou une incontinence urinaire d'effort (I, A).

Obstetric anal sphincter injuries (OASI) are severe complications that can cause considerable short- and long-term morbidity. Austria, Canada, Norway, and Sweden have similar socio-economic characteristics, and all four countries have access to national birth registers. In this study, we hypothesized that the incidence of OASI should be very similar for different obstetric scenarios in these four countries. Therefore, the aim was to compare the incidence of OASI in these four countries in primiparous women, with spontaneous or instrumental delivery (vacuum or forceps), and in women with a first vaginal birth after cesarean section (VBAC). Aggregated data on 1 933 930 vaginally delivered primiparous women and women with VBAC were retrieved from the birth registers gathered in Austria, Canada, Norway, and Sweden. The annual rate of OASI (ICD-10 codes O70.2–O70.3) was presented as the percentage of women with a spontaneous delivery, vacuum or forceps delivery, and a VBAC during the period 2004–2016. The incidence of OASI varied considerably between countries and over time. Canada and Sweden had the highest rates, and Austria and Norway the lowest. In Norway, the rate of OASI decreased consistently for all types of deliveries after introducing a perineal protection program in 2004 ( p  < 0.001). During vacuum delivery, the incidence of OASI varied between countries from 4.1% to 15.5% across the study period. In Canada and Norway, the rate of OASI after a forceps delivery was similar in 2004 at ~20% and with differing trajectories to 24.3% (β 0.49) and 6.2% (β −1.15) (trend, all p  < 0.001) in 2016. This comparative register study suggests that there may be considerable potential for lowering the incidence of OASI. The perineal protection program implemented by Norway has been successful. Each country should critically, without prejudice, analyze their current clinical practices and rate of OASI and consider the best preventive strategy.

Obstetric anal sphincter injuries (OASI) are severe complications that can cause considerable short‐ and long‐term morbidity. Austria, Canada, Norway, and Sweden have similar socio‐economic characteristics, and all four countries have access to national birth registers. In this study, we hypothesized that the incidence of OASI should be very similar for different obstetric scenarios in these four countries. Therefore, the aim was to compare the incidence of OASI in these four countries in primiparous women, with spontaneous or instrumental delivery (vacuum or forceps), and in women with a first vaginal birth after cesarean section (VBAC).

We have read with great interest the thoughtful commentary by Drs. Levin and Rottenstreich on our study. 1 Frenette P Crawford S Schulz J et al. Impact of episiotomy during operative vaginal delivery on obstetrical anal sphincter injuries. J Obstet Gynaecol Can. 2019; https://doi.org/10.1016/j.jogc.2019.02.016 Abstract Full Text Full Text PDF Scopus (7) Google Scholar They have further illustrated the complexity associated with delineating the effect of episiotomy on obstetric anal sphincter injuries (OASIS) in the setting of operative vaginal delivery. Because of journal space constraints, a more extensive review of the literature was not possible in our introduction. However, you correctly point to two recent studies that have shown a protective effect of mediolateral episiotomy among vacuum-assisted deliveries of primiparous women. 2 Lund NS Persson LK Jangö H et al. Episiotomy in vacuum-assisted delivery affects the risk of obstetric anal sphincter injury: a systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol. 2016; 207: 193-199 Abstract Full Text Full Text PDF PubMed Scopus (66) Google Scholar , 3 van Bavel J Hukkelhoven CWPM de Vries C et al. The effectiveness of mediolateral episiotomy in preventing obstetric anal sphincter injuries during operative vaginal delivery: a ten-year analysis of a national registry. Int Urogynecol J. 2018; 29: 407-413 Crossref PubMed Scopus (59) Google Scholar Interestingly, a subgroup analysis of more than 260 000 births within the meta-analysis by Lund et al. revealed no statistically significant difference in rates of severe perineal trauma when limited to studies where the frequency of episiotomy was <75%. 2 Lund NS Persson LK Jangö H et al. Episiotomy in vacuum-assisted delivery affects the risk of obstetric anal sphincter injury: a systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol. 2016; 207: 193-199 Abstract Full Text Full Text PDF PubMed Scopus (66) Google Scholar Similarly, in the large cohort study by van Bavel et al., which revealed a protective effect, episiotomy was performed in >85% of vacuum deliveries among primiparous women. 3 van Bavel J Hukkelhoven CWPM de Vries C et al. The effectiveness of mediolateral episiotomy in preventing obstetric anal sphincter injuries during operative vaginal delivery: a ten-year analysis of a national registry. Int Urogynecol J. 2018; 29: 407-413 Crossref PubMed Scopus (59) Google Scholar Sagi-Dain and Sagi also found no statistically significant difference in OASIS rates in their meta-analysis of six observational studies where the frequency of episiotomy among vacuum-assisted deliveries of primiparous women was <71%. 4 Sagi-Dain L Sagi S Morbidity associated with episiotomy in vacuum delivery: a systematic review and meta-analysis. BJOG. 2015; 122: 1073-1081 Crossref PubMed Scopus (43) Google Scholar Taken together, these findings suggest that mediolateral episiotomy may not be beneficial for preventing severe perineal trauma when it is applied in a restrictive fashion. One possible explanation is that it is difficult to reliably identify women at highest risk of OASIS in whom an episiotomy would be beneficial. However, an alternative liberal approach to episiotomy may not be desirable even if it protects against OASIS because mediolateral episiotomy itself has been associated with significant adverse effects, including anal incontinence. 5 Sartore A De Seta F Maso G et al. The effects of mediolateral episiotomy on pelvic floor function after vaginal delivery. Obstet Gynecol. 2004; 103: 669-673 Crossref PubMed Scopus (119) Google Scholar , 6 LaCross A Groff M Smaldone A Obstetric anal sphincter injury and anal incontinence following vaginal birth: a systematic review and meta-analysis. J Midwifery Womens Health. 2015; 60: 37-47 Crossref PubMed Scopus (82) Google Scholar We look forward to the results of the upcoming trial evaluating routine use of episiotomy in the setting of vacuum-assisted deliveries; however, it may also be helpful to evaluate the effect of restrictive use versus no episiotomy in a randomized controlled trial. Letter: The Type of Episiotomy Should Be Studied CarefullyJournal of Obstetrics and Gynaecology Canada Vol. 41Issue 11PreviewWe read the study by Frenette et al., published recently in JOGC, with great interest.1 These authors retrospectively investigated the incidence and risk factors associated with obstetric anal sphincter injuries (OASIS) during operative vaginal delivery among parous and nulliparous women. Despite their large retrospective cohort study, some issues deserve further clarification. Full-Text PDF

Objective: The purpose of this study was to describe associations between episiotomy at the time of forceps or vacuum-assisted delivery and obstetrical anal sphincter injuries (OASIS). Methods: This population-based retrospective cohort study used delivery information from a provincial perinatal clinical database. Full-term, singleton, in-hospital, operative vaginal deliveries of vertex-presenting infants from April 1, 2006 to March 31, 2016 were identified. Odds ratios (ORs) and 95% confidence intervals (CIs) for associations between episiotomy and third- or fourth-degree lacerations were calculated in multiple logistic regression models (Canadian Task Force Classification II-2). Results: Episiotomy was performed in 34% of 52 241 operative vaginal deliveries. OASIS occurred in 21% of forceps deliveries and 7.6% of vacuum deliveries. Episiotomy was associated with increased odds of severe perineal lacerations for vacuum deliveries among women with (OR 2.48; 95% CI 1.96-3.13) and without (OR 1.12; 95% CI 1.02-1.22) a prior vaginal delivery. Among forceps deliveries, episiotomy was associated with increased odds of OASIS for those with a previous vaginal delivery (OR 1.52; 95% CI 1.12-2.06), but it was protective for women with no previous vaginal delivery (OR 0.73; 95% CI 0.67-0.79). Midline compared with mediolateral episiotomy increased the odds of OASIS in forceps deliveries (OR 2.73; 95% CI 2.37-3.13) and vacuum deliveries (OR 1.94; 95% CI 1.65-2.28). Conclusion: In conclusion, results suggest that episiotomy should be used with caution, particularly among women with a previous vaginal delivery and in the setting of vacuum-assisted delivery. Episiotomy may protect against OASIS in forceps-assisted deliveries for women without a prior vaginal delivery. (C) 2019 The Society of Obstetricians and Gynaecologists of Canada/La Societe des obstetriciens et gynecologues du Canada. Published by Elsevier Inc. All rights reserved.

INTRODUCTION: There is a growing body of literature outlining the adverse consequences of excess body weight in pregnancy. In particular, this has demonstrated an increased rate of cesarean delivery. To date, there is no risk stratification tool to determine which women, with obesity and who are undergoing an induction of labor, are at the greatest risk of cesarean delivery. This study aims to validate the use of a modified Edmonton Obesity Staging System (EOSS) to predict mode of delivery amongst these women. METHODS: A prospective-cohort study was performed at two high obstetrical volume centers in Edmonton, Alberta. A total of 345 nulliparous women, undergoing an induction of labor at term, were recruited. Participating women provided a self-reported health survey and allowed for review of their medical records. The sample population included women with a body mass index (BMI) of ≥25.0 at first antenatal visit. The primary outcome is the rate of cesarean delivery. RESULTS: Overall, 345 women were recruited into this study with a participation rate of 93.7%. This included a sample group of 276 women, with an increased BMI, and a control group of 69 normal-weight women. Preliminary data analysis determined a cesarean delivery rate of 30.4% for the control group and 35.8%, 29.9%, 43.2%, and 90.5% for women assigned an EOSS Stage 0, 1, 2, and 3, respectively. CONCLUSION: A modified version of the EOSS may help stratify the risk of cesarean delivery in nulliparous women, with an increased BMI, who are undergoing an induction of labor.

OBJECTIVE:This study sought to evaluate the use of the Edmonton Obesity Staging System (EOSS) in predicting cesarean delivery among term, nulliparous, singleton pregnancies in women with overweight or obesity who are undergoing an induction of labour. METHODS:A prospective cohort study was performed in Edmonton, Alberta. Women undergoing an induction of labour at term were recruited to either a sample cohort, including women with a body mass index of ≥25 kg/m2 at first antenatal visit, or a control cohort with a body mass index of 18.5 to 24.9 kg/m2. Participating women provided a self-reported health history and consented to review of their medical records allowing allocation into EOSS categories. The primary outcome was the rate of cesarean delivery based on EOSS category. Secondary outcomes consisted of a summary score of adverse maternal, delivery, and neonatal events (Canadian Task Force Classification II-2). RESULTS:Overall, 345 women were recruited, with a participation rate of 93.7%. The sample cohort consisted of 276 women with overweight or obesity, whereas the control cohort included 69 normal-weight women. The overall rate of cesarean delivery was 30.4% for the control cohort and 35.8%, 29.9%, 43.2%, and 90.5% for women assigned an EOSS category 0, 1, 2, and 3, respectively (P < 0.001). A summary score was not indicative of overall rate of adverse maternal, delivery, and neonatal events (P = 0.22). CONCLUSION:The EOSS may help predict the chance of cesarean delivery in a high-risk group of nulliparous women with overweight or obesity who are undergoing an induction of labour at term.