scholarly journals Outcomes of elective induction of labour compared with expectant management: population based study

BMJ ◽  
2012 ◽  
Vol 344 (may10 3) ◽  
pp. e2838-e2838 ◽  
Author(s):  
S. J. Stock ◽  
E. Ferguson ◽  
A. Duffy ◽  
I. Ford ◽  
J. Chalmers ◽  
...  
Keyword(s):  
Expectant Management ◽  
Population Based ◽  
Induction Of Labour ◽  
Population Based Study ◽  
Elective Induction

scholarly journals Elective induction of labour at 39 weeks versus expectant management up to 41 weeks in a tertiary care centre

2020 ◽  
Vol 9 (2) ◽  
pp. 794
Author(s):  
Yogindra M. Kabadi ◽  
Sanjana Kumar
Keyword(s):  
Cesarean Section ◽  
Gestational Age ◽  
Perinatal Outcome ◽  
Tertiary Care ◽  
Expectant Management ◽  
Induction Of Labour ◽  
Labour Induction ◽  
Perinatal Deaths ◽  
Elective Induction ◽  
Singleton Pregnancies

Background: The timing of delivery and effective management of labour at term makes a huge difference in the obstetric and perinatal outcome. There have always been controversies between choosing the elective induction of labour at 39 weeks versus expectant management up to 41/42 weeks which can result in placental ageing, reduced liquor, non-assuring fetal heart tracings, meconium stained amniotic fluid and fetal macrosomia.  our objective was to perform a comparative effectiveness analysis of elective induction of labor at 39 weeks gestational age among nulliparous women with uncomplicated singleton pregnancies as compared to expectant management up to 41 weeks.Methods: 120 primigravidae with singleton pregnancies with fetus in cephalic presentation were recruited into the study and divided into 2 groups of 60 each A: Patients were induced electively using dinoprostone gel (maximum 3 doses 8 hours apart) B: They were managed expectantly up to 41 weeks allowing for spontaneous onset of labour, induction or cesarean section was done for obstetric indications between 39 and 41 weeks and pregnancy was  terminated by induction for those who continued up to 41 weeks. Their obstetric and perinatal outcome were noted.Results: The cesarean section rates were higher in the expectantly managed group (21%) when compared to the electively induced group (16%). The same was with instrumental delivery rates (15% versus 10%). The perinatal outcome was poorer for the expectantly managed group with 20% NICU admissions and 5% perinatal deaths compared to the electively induced group which had 12% NICU admissions and 3.3% perinatal deaths. The expectantly managed group also resulted in respiratory distress in a larger number of fetuses and resulted in problems due to reduced liquor.Conclusions: Elective induction at 39 weeks gestational age was found to be a better option compared to expectant management up to 41 weeks in terms of obstetric and perinatal outcomes.

Outcomes of Elective Induction of Labour Compared With Expectant Management

2012 ◽  
Vol 67 (9) ◽  
pp. 529-530 ◽  
Author(s):  
Sarah J. Stock ◽  
Evelyn Ferguson ◽  
Andrew Duffy ◽  
Ian Ford ◽  
James Chalmers ◽  
...  
Keyword(s):  
Expectant Management ◽  
Induction Of Labour ◽  
Elective Induction

Comparison of effectiveness and safety of cervical ripening methods for induction of labour: A population‐based study using coarsened exact matching

2019 ◽  
Vol 33 (5) ◽  
pp. 313-322
Author(s):  
Pauline Blanc‐Petitjean ◽  
Bruno Carbonne ◽  
Catherine Deneux‐Tharaux ◽  
Marina Salomé ◽  
François Goffinet ◽  
...  
Keyword(s):  
Population Based ◽  
Induction Of Labour ◽  
Cervical Ripening ◽  
Exact Matching ◽  
Population Based Study ◽  
Coarsened Exact Matching ◽  
Comparison Of Effectiveness

Trends in induction of labour, 1998–2007: A population-based study

2009 ◽  
Vol 49 (6) ◽  
pp. 599-605 ◽  
Author(s):  
N. M. MEALING ◽  
C. L. ROBERTS ◽  
J. B. FORD ◽  
J. M. SIMPSON ◽  
J. M. MORRIS
Keyword(s):  
Population Based ◽  
Induction Of Labour ◽  
Population Based Study

Risk of Expectant Management and Optimal Timing of Delivery in Low-Risk Term Pregnancies: A Population-Based Study

2017 ◽  
Vol 35 (03) ◽  
pp. 262-270 ◽  
Author(s):  
Sarah Nazeer ◽  
Komal Kumar ◽  
Morgan Warren ◽  
Jing Dai ◽  
Robert Sokol ◽  
...  
Keyword(s):  
Gestational Age ◽  
Expectant Management ◽  
Population Based ◽  
Optimal Timing ◽  
Maternal Complications ◽  
Population Based Study ◽  
Neonatal Complications ◽  
Early Term ◽  
Management Group ◽  
Increased Risk

Objective The benefits of the 39-week rule have been questioned and concerns of increased stillbirth after adoption of this rule have been raised. Whether expectant management risks outweigh the benefits of awaiting 39 weeks has not been studied. We analyze the risks of expectant management at term and the optimal timing for delivery. Study Design All U.S. nonanomalous singleton term deliveries in 2013 were selected, excluding diabetes/hypertension, and low birth weight. Maternal/neonatal complications and stillbirth/infant death were compared among expectant management versus deliveries at each term gestational age. Logistic regression was used to calculate adjust odds ratios of complications according to delivery plan at each gestational age. Results From approximately 3 million deliveries, maternal complications during expectant management were lower at early term, and became higher at 39 weeks, relative risk [RR] (95% confidence interval [CI]) = 1.18 (1.16–1.19). Neonatal complications during expectant management were lower during early term, and became higher at ≥39 weeks, RR (95% CI) = 1.09 (1.08–1.09). The risk of perinatal mortality in the expectant management group was lower during early term, and became higher at ≥39 weeks, 18.93 (17.83–20.10) versus 17.37 (16.61–18.16), p = 0.010. Conclusion Complications during expectant management occurring while awaiting full term do not outweigh the benefits of better outcomes from reaching 39 weeks. However, extending beyond 39 weeks may put these pregnancies at an increased risk.

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