Induction of Labour in Growth Restricted and Small for Gestational Age Foetuses – A Historical Cohort Study

Abstract

Purpose Induction of labour for small-for-gestational-age (SGA) foetus or intrauterine growth restriction (IUGR) is common, but data are limited. The aim of this study was therefore to compare labour induction for SGA/IUGR with cases of normal foetal growth above the 10th percentile. Material and Methods This historical multicentre cohort study included singleton pregnancies at term. Labour induction for SGA/IUGR (IUGR group) was compared with cases of foetal growth above the 10th percentile (control group). Primary outcome measure was caesarean section rate. Results The caesarean section rate was not different between the 2 groups (27.0 vs. 26.2%, p = 0.9154). In the IUGR group, abnormal CTG was more common (30.8 vs. 21.9%, p = 0.0214), and foetal blood analysis was done more often (2.5 vs. 0.5%, p = 0.0261). There were more postpartum transfers to the NICU in the IUGR group (40.0 vs. 12.8%, p < 0.0001), too. Conclusion Induction of labour for foetal growth restriction was not associated with an increased rate of caesarean section.

Analysis of Factors Associated With Variability and Acidosis of the Umbilical Artery pH at Birth

“…According to induction reason, intrauterine growth restriction is one of the main risk factors for intrapartum fetal acidosis in our results and in those of Kehl et al (35), Pinton et al (36), and Massimiani et al (37), with more postpartum transfers to the neonatal intensive care unit and high perinatal mortality and morbidity (35), this placental dysfunction predisposes the fetus to intrapartum fetal compromise.…”

Amniotic-Umbilical-to-Cerebral Ratio – A Novel Ratio Combining Doppler Parameters and Amniotic Fluid Volume to Predict Adverse Perinatal Outcome in SGA Fetuses At Term

“…Clinical management followed local protocols and guidelines as described in a recent publication [6]. Induction of labor was performed as a sequential approach [23]. First, we used a cervical double-balloon catheter system (Cook Medical, Cervical Ripening Balloon, Cook OB/GYN, Bloomington, Indiana, USA), which was inserted in the evening and was removed after 12 hours.…”

Induction of Labor at Term with Oral Misoprostol or as a Vaginal Insert and Dinoprostone Vaginal Insert – A Multicenter Prospective Cohort Study

“…In Germany, labor was induced in 21.9% of all births and 33% of all late-term pregnancies in 2019 8 . It has been proven that induction of labor has the benefit of reducing maternal and child morbidity, and also reducing the rate of operative deliveries 5 9 10 11 . Prostaglandin analogs are considered the method of choice for induction of labor at term, subject to pre-existing cervical maturation 12 13 .…”

“…In Deutschland wurden 2019 21,9% aller Geburten und 33% aller Terminüberschreitungen eingeleitet 8 . Der Nutzen einer Geburtseinleitung zur Senkung der mütterlichen und kindlichen Morbidität und ebenso der Rate operativer Geburtsbeendigungen ist belegt 5 9 10 11 . Für die Geburtseinleitung am Termin gelten Prostaglandin-Analoga in Abhängigkeit der vorbestehenden Zervixreifung als Mittel der Wahl 12 13 .…”