Labor induction at 41

expectant management labor induction late-term pregnancy post-term pregnancy prolonged pregnancy

Journal

Acta obstetricia et gynecologica Scandinavica
ISSN: 1600-0412
Titre abrégé: Acta Obstet Gynecol Scand
Pays: United States
ID NLM: 0370343

Informations de publication

Date de publication:
19 Dec 2023
Historique:
revised: 18 11 2023
received: 22 09 2023
accepted: 01 12 2023
medline: 19 12 2023
pubmed: 19 12 2023
entrez: 19 12 2023
Statut: aheadofprint

Résumé

Neonatal and maternal risks increase in term pregnancy as gestational age advances and become increasingly evident post-term. Management practices of late- and post-term pregnancies vary, and the optimal time point for intervention by labor induction is yet to be determined. This randomized controlled trial of 381 nulliparous women with unripe cervices compared labor induction at 41 The rates of CS (16.7% [n = 31] vs. 24.1% [n = 47], RR 0.7 [95% CI: 0.5-1.0], p = 0.07) and a composite of adverse neonatal outcomes (9.7% [n = 18] vs. 14.4% [n = 28], RR 0.7 [95% CI: 0.4-1.2] p = 0.16) did not significantly differ between the groups, but the operative delivery rate was lower in the early induction group than in the expectant management group (30.6% [n = 57] vs. 45.6% [n = 89], p = 0.003). The rates of hemorrhage ≥1000 mL and neonatal weight ≥4000 g were also lower in the early induction group, as was the vacuum extraction rate in women with vaginal delivery. Of the women with expectant management, 45.6% (n = 89) had spontaneous onset of labor. No perinatal deaths occurred, but one case of eclampsia appeared in the expectant management group. Offering labor induction to nulliparous women at 41

Identifiants

pubmed: 38112629
doi: 10.1111/aogs.14755
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2023 The Authors. Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG).

Références

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Auteurs

Katariina Place (K)

Department of Obstetrics and Gynecology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.

Leena Rahkonen (L)

Department of Obstetrics and Gynecology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.

Aydin Tekay (A)

Department of Obstetrics and Gynecology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.

Kirsi Väyrynen (K)

Department of Obstetrics and Gynecology, Central Finland Central Hospital, Jyväskylä, Finland.

Maija-Riitta Orden (MR)

Department of Obstetrics and Gynecology, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland.

Marja Vääräsmäki (M)

Clinical Medicine Research Unit, Department of Obstetrics and Gynecology, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.

Jukka Uotila (J)

Department of Obstetrics and Gynecology, Tampere University Hospital and Tampere University, Tampere, Finland.

Kati Tihtonen (K)

Department of Obstetrics and Gynecology, Tampere University Hospital and Tampere University, Tampere, Finland.

Kirsi Rinne (K)

Department of Obstetrics and Gynecology, Turku University Hospital and University of Turku, Turku, Finland.

Kaarin Mäkikallio (K)

Department of Obstetrics and Gynecology, Turku University Hospital and University of Turku, Turku, Finland.

Seppo Heinonen (S)

Department of Obstetrics and Gynecology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.

Heidi Kruit (H)

Department of Obstetrics and Gynecology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.

Classifications MeSH