scholarly journals Offspring education outcome at age 12 after induction of labour versus expectant management at term

2022 ◽  
Vol 226 (1) ◽  
pp. S728-S729
Author(s):  
Renée J. Burger ◽  
Eva Pajkrt ◽  
Ben W. Mol ◽  
Wessel Ganzevoort ◽  
Sanne J. Gordijn ◽  
...  
Keyword(s):  
Expectant Management ◽  
Induction Of Labour

scholarly journals Bayesian Scepsis About SWEPIS: Quantifying the Evidence That Early Induction of Labour Prevents Perinatal Deaths

2020 ◽  
Author(s):  
Eric-Jan Wagenmakers ◽  
Alexander Ly
Keyword(s):  
Clinical Trial ◽  
Bayesian Analysis ◽  
Randomized Clinical Trial ◽  
Clinical Studies ◽  
Expectant Management ◽  
Induction Of Labour ◽  
Perinatal Deaths ◽  
Management Group ◽  
Induction Group

In a recent randomized clinical trial, Wennerholm and colleagues compared induction of labour at 41 weeks with expectant management and induction at 42 weeks. The trial was stopped early, because six perinatal deaths occurred in the expectant management group, whereas none occurred in the induction group. Our Bayesian reanalysis finds that the SWEPIS data indeed support the hypothesis that induction of labour at 41 weeks of pregnancy is associated with a lower rate of stillbirths. However, the degree of this support is moderate at best, and arguably provides insufficient ground for terminating the study. In general, it seems hazardous to terminate clinical studies on the basis of a single P<0.05 result, without converging support of a Bayesian analysis.

Prolonged pregnancy

2020 ◽  
pp. 389-394
Author(s):  
Kate F. Walker ◽  
Jim G. Thornton
Keyword(s):  
Caesarean Section ◽  
Pregnancy Loss ◽  
Expectant Management ◽  
Induction Of Labour ◽  
Morbidity And Mortality ◽  
Perinatal Morbidity ◽  
Increased Risk ◽  
Oxytocin Infusion ◽  
Prolonged Pregnancy ◽  
Overall Risk

Prolongation of gestation beyond 42+0 weeks (or 294 days) affects about 6% of pregnancies. It is associated with an increased risk of perinatal morbidity and mortality; the overall risk of pregnancy loss (stillbirth plus death occurring up to the age of 1 year) increases eightfold between 37 weeks and 43 weeks. Since trials comparing induction of labour with expectant management suggest that induction does not increase the rate of caesarean section, many clinicians offer it for pregnancies beyond 41 weeks. Induction of labour is usually performed using prostaglandin ripening followed, if necessary, by amniotomy and oxytocin infusion.

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