Obesity is one of the biggest public health problems of the 21st century as it increases the risk of many co-morbid medical conditions. Obesity in pregnancy places women at higher risk of obstetrical complications during pregnancy, delivery and puerperium. Obesity is a risk factor for cesarean delivery, failed induction of labor and labor dystocia, and prolonged labor curves especially among women with class III obesity.

Inclusion Criteria:

• Spontaneous onset of labor.
• Body mass index ≥ 30 kg/m2.
• Gestational age ≥ 37 weeks.
• Singleton pregnancy.
• Cephalic presentation.
• Reassuring fetal heart rate monitoring.
• Inefficient uterine contractions during active labor
• Women who will accept to participate in the study.

Exclusion Criteria:

• Non-reassuring fetal assessment at the time of recruitment.
• Women received cervical ripening agents.
• Any patients contraindicated for vaginal delivery.
• Multiple gestations.
• Malpresentation.
• Previous cesarean delivery.
• Patients with cardiac diseases, pre-eclampsia or any other medical disorders.
• Fetal demise.
• Intrauterine growth restriction.
• Estimated fetal weight ≥ 5000 grams.
• Pre-labor rupture of membranes > 24 hours.