SPONTANEOUS LABOUR AND ELECTIVE INDUCTION—A PROSPECTIVE RANDOMIZED STUDY <i>Behavioural Assessment and Neurological Examination in the Newborn Period</i>

Leijon, Ingemar; Finnström, Orvar; Hedenskog, Staffan; Rydén, Gunnar; Tylleskär, John

doi:10.1111/j.1651-2227.1979.tb05054.x

Cited by 21 publications

(10 citation statements)

References 30 publications

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“…We initially identified 18 trials evaluating the effectiveness of induction of labor in women with full‐term pregnancies . Eleven studies were excluded .…”

Section: Resultsmentioning

confidence: 99%

“…We initially identified 18 trials evaluating the effectiveness of induction of labor in women with full-term pregnancies. [4][5][6][7][8][13][14][15][18][19][20][21][22][23][24][25][26][27] Eleven studies were excluded. [13][14][15]18,25 Seven randomized clinical trials, including 7598 participants, which met the inclusion criteria for this meta-analysis, were analyzed.…”

Section: Study Selection and Study Characteristicsmentioning

confidence: 99%

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Induction of labor at full‐term in pregnant women with uncomplicated singleton pregnancy: A systematic review and meta‐analysis of randomized trials

Saccone

Corte

Maruotti

et al. 2019

Acta Obstet Gynecol Scand

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Introduction The lowest incidence of perinatal morbidity and mortality occurs around 39‐40 weeks. Therefore, some have advocated induction of uncomplicated singleton gestations once they reach full‐term. The aim of the study was to evaluate the risk of cesarean delivery, and any maternal and perinatal effects of a policy of induction of labor in women with full‐term uncomplicated singleton gestations. Material and methods We performed an electronic search from inception of each database to August 2018. All results were then limited to randomized trial. No restrictions for language or geographic location were applied. Inclusion criteria were randomized clinical trials of asymptomatic women with uncomplicated, singleton gestations at full‐term (ie, between 39+0 and 40+6 weeks) who were randomized to either planned induction of labor or control (ie, expectant management). Only trials on asymptomatic singleton gestations without premature rupture of membranes or any other indications for induction evaluating the effectiveness of planned induction of labor in full‐term singleton gestations were included. The primary outcome was the incidence of cesarean delivery. Results Seven randomized clinical trials, including 7598 participants were analyzed. Three studies enrolled only women with favorable cervix, defined as a Bishop score of ≥5 in nulliparous women or ≥4 in multiparous women. One trial included only women aged 35 years or older. Women randomized to the planned induction of labor, received scheduled induction usually at 39+0 to 39+6 weeks of gestation, whereas women in the control group received expectant management usually until 41‐42 weeks of gestation, or earlier if medically indicated. Methods of induction usually included cervical ripening, with either misoprostol or Foley catheter, in conjunction with or followed by oxytocin for women with unfavorable cervix, and oxytocin and artificial rupture of membranes for those with favorable cervix. Five trials also used artificial rupture of membranes as a method for induction. Uncomplicated full‐term singleton gestations that were randomized to receive induction of labor had similar incidence of cesarean delivery compared with controls (18.6% vs 21.4%; relative risk 0.96, 95% CI 0.78‐1.19). Regarding neonatal outcomes, induction of labor at full‐term was associated with a significantly lower rate of meconium‐stained amniotic fluid (4.0% vs 13.5%; relative risk 0.32, 95% CI 0.18‐0.57), and lower mean birthweight (mean difference −98.96 g, 95% CI −126.29 to −71.63) compared with the control group. There were no between‐group differences in other adverse neonatal outcomes. Conclusions Induction of labor at about 39 weeks is not associated with increased risk of cesarean delivery.

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“…We initially identified 18 trials evaluating the effectiveness of induction of labor in women with full‐term pregnancies . Eleven studies were excluded .…”

Section: Resultsmentioning

confidence: 99%

Section: Study Selection and Study Characteristicsmentioning

confidence: 99%

Induction of labor at full‐term in pregnant women with uncomplicated singleton pregnancy: A systematic review and meta‐analysis of randomized trials

Saccone

Corte

Maruotti

et al. 2019

Acta Obstet Gynecol Scand

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show abstract

“…The first fundus examination was done within 24 hours of birth, and if there were retinal hemorrhages the infants were re-examined on day 3 or 4. The infants were examined on days 1 and 5 by one of the two pediatricians using a standardized neonatal neurological examination, based mainly on Prechtl (6) as described elsewhere (7). This included 31 items, most of which were evaluated on a 4-point scale (Table I).…”

Section: Methodsmentioning

confidence: 99%

Forceps or Vacuum Extraction? A Comparison of Effects on the Newborn Infant

Fall¹,

Rydén²,

Finnström³

et al. 1987

Obstetrical & Gynecological Survey

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Sixteen women delivered by forceps and 20 women delivered by vacuum extraction (VE) owing to secondary uterine inertia were compared with a control group of 11 women who gave birth spontaneously. The cord arterial pH was lower in the VE group than in the forceps and control groups. Base deficit in both arterial and venous cord blood was greater in the VE group than in the forceps group, probably owing to the longer application and extraction times in VE than in .forceps delivery. The incidence of retinal hemorrhage did not differ between the forceps and VE groups. The incidence of cephalhematomata was greater among VE infants than in the forceps and control groups.All infants were examined on the 1st and 5th day by standardized neurological and behavioural examination. There were no significant differences in neurological status between the forceps and VE groups. Thus, in low extraction with no signs of fetal asphyxia, either method can be used with safety if the obstetrician is familiar with both methods of operative vaginal delivery.

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“…This paper will deal mainly with mother and fetus. In other papers the neurological state of the newborn during the neonatal period (17) and the incidence of hyperbilirubinemia (18) have been investigated.…”

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confidence: 99%

Spontaneous Labor and Elective Induction—a Prospective Randomized Study

Tylleskär

Finnström

Leijon

et al. 1979

Acta Obstet Gynecol Scand

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In a prospective randomized study spontaneous and oxytocin induced labor "for convenience" have been compared with respect to uterine activity, duration of labor, the condition of the fetus and the newborn infant. The study consists of 84 normal patients, of whom 43 were induced at full term by amniotomy and oxytocin infusion using the Cardiff Infusion System Mark II; 41 patients served as controls. No difference in maternal age, number of previous pregnancies and pelvic score one week before the day of delivery were found between the groups. The following parameters were calculated: duration of labor, uterine activity, amount of bleeding in the third stage of labor, number of early and late decelerations as well as number of episodes of bradycardia in the CTG-recordings, birth weight, Apgar score one and five minutes post-delivery and blood gases in mother and child 60 seconds after delivery. No significant differences between the two groups were found. It is concluded that there are no increased risks to mother or fetus compared to normal labor provided that there is cephalic presentation and normal pregnancy, careful selection with respect to the length of pregnancy and the condition of the cervix and that the Cardiff infusion system is used with intrauterine pressure recording and continuous fetal heart monitoring.

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SPONTANEOUS LABOUR AND ELECTIVE INDUCTION—A PROSPECTIVE RANDOMIZED STUDY Behavioural Assessment and Neurological Examination in the Newborn Period

Cited by 21 publications

References 30 publications

Induction of labor at full‐term in pregnant women with uncomplicated singleton pregnancy: A systematic review and meta‐analysis of randomized trials

Induction of labor at full‐term in pregnant women with uncomplicated singleton pregnancy: A systematic review and meta‐analysis of randomized trials

Forceps or Vacuum Extraction? A Comparison of Effects on the Newborn Infant

Spontaneous Labor and Elective Induction—a Prospective Randomized Study

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