Success of labor induction for pre-eclampsia at preterm and term gestational ages

Roland, Cynthia; DeFranco, EA

doi:10.1038/jp.2017.31

Cited by 12 publications

(10 citation statements)

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“…In half of the women, labor was induced, and the remainder underwent cesarean delivery without labor.Induction was successful in accomplishing vaginal delivery in a third. Others have reported similar observations (Roland, 2017 ) [15] . Unfortunately, none of these studies further analyzed the failure causes of vaginal trial.When multiple logistic regression analysis was performed,this study got that cephalopelvic disproportion(OR ¼ 2.13; 95% CI: 1.43-8.13) and fetal distress (OR¼2.42; 95% CI: 1.76-6.65) remained signi cantly associated with transfer-cesarean section,which is consistent with the risk factors of conversion to cesarean section during vaginal delivery in normal pregnant.And it can alleviate the anxiety of obstetricians and pregnants that the maternal and fetal'preeclampsia conditions would worsen during vaginal delivery in some extent .…”

Section: Risk Factors Of Transfer-cesarean Sectionsupporting

confidence: 66%

Risk Factors and Maternal-Fetal Outcomes of Pregnant with Preeclampsia Who Converted to Cesarean Section After A Trial Vaginal Birth

Yan²,

Chen³

2020

Preprint

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Background: At present, most pregnant with preeclampsia choose direct cesarean section. Whether cesarean section after vaginal trial affects the outcome of mother and child and its related risk factorsIt are still unclear. The purpose of this study is to investigate the risk factors and maternal-neonatal outcomes in severe preeclampsia patients who undergo transfer-cesarean section during vaginal labor. Methods: For this retrospective study, patient with severe preeclampsia data from 2015 to 2019 was collected. Study participants were women with severe preeclampsia having a cesarean section during week 34 and 41 of gestation.The population was classified into three groups: patients with severe preeclampsia had cesarean section directly, patients with severe preeclampsia had vaginal deliveries and patients with severe preeclampsia who sufferred from transfer-cesarean section in the vaginal labor. The demographic variables and maternal-fetal outcomes were collected and analyzed. Results: (1) 34%(553/1626) severe preeclampsia had labor induction or natural labor and the ratio of transfer-cesarean section after trial of labor was 39% (216/553) . (2)There was a greater incidence of postpartum haemorrhage (7.7% versus 4.5%),the need for blood transfusion (2.4% versus 0.6%) and more than 7 days of hospitalization (10.4% versus 0.6%) in patients submitted to direct caesarean section compared with vaginal delivery.Apgar score at 5 min <7score and admission of NICU (7.5% versus 2.7%;26.0% versus 18.4%) in the neonates were significantly higher in the direct cesarean section group compared with vaginal delivery,but no difference between direct cesarean section group and transfer cesarean section.(3)When multiple logistic regression analysis was performed,the variables that remained significantly associated with transfer cesarean section were cephalopelvic disproportion (OR ¼ 2.13; 95% CI: 1.43–8.13) and fetal distress (OR ¼ 2.42; 95% CI: 1.76–6.65). Conclusion: Vaginal delivery can be recommended to pregnants with severe preeclampsia as long as there are no contraindications for vaginal delivery. Attempting but failing vaginal delivery would not increase the complications of mother and neonates,but fetal monitoring and labor evaluation should be strengthen during the process of labor.

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Section: Risk Factors Of Transfer-cesarean Sectionsupporting

confidence: 66%

Risk Factors and Maternal-Fetal Outcomes of Pregnant with Preeclampsia Who Converted to Cesarean Section After A Trial Vaginal Birth

Yan²,

Chen³

2020

Preprint

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“…There was no increased risk of CD among women with past placenta-mediated pregnancy complication who underwent induction of labor, compared to spontaneous labor. Our data adds to a reassuring and growing body of literature that suggests there is no increased CD risk based on these indications for induction [12][13][14][15][16] . While our results are not generalizable to a low-risk obstetrical population, they support the results of the randomized ARRIVE Trial that showed a decreased risk of CD among low-risk nulliparous women randomized to induction of labor (18.6% versus 22.2%, RR 0.84, 95% CI 0.76-0.93) 10 , with a difference in CD rates that persisted across the pre-specified subgroups of age, ethnicity, body mass index and modified Bishop score.…”

Section: Discussionmentioning

confidence: 55%

“…Medical indications for induction are heterogeneous, and may influence the risk of CD to varying degrees. Based on a limited number of studies, there is likely no increased risk of cesarean delivery after induction of labor among patients with pre-eclampsia or chronic hypertension, with improved maternal outcomes [12][13][14][15][16] . Women who have a previous history of late pregnancy loss, pre-term birth, or delivery of a small-for-gestational-age (SGA) infant are at increased risk of developing complications such as a stillbirth in a future pregnancy 17 .…”

mentioning

confidence: 99%

The risk of cesarean delivery after labor induction among women with prior pregnancy complications: A subgroup analysis of the AFFIRM study

Skeith

Gal

Vries

et al. 2019

Preprint

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Objective: To determine the risk of cesarean delivery after labor induction among patients with prior placenta-mediated pregnancy complications (pre-eclampsia, late pregnancy loss, placental abruption or intrauterine growth restriction). Study Design: The AFFIRM database includes patient level data from 9 randomized controlled trials that evaluated the role of LMWH versus no LMWH during pregnancy to prevent recurrent placenta-mediated pregnancy complications. The primary outcome of this sub-study was the proportion of women who had an unplanned cesarean delivery after induction of labor compared to after spontaneous labor. Results: There were 512 patients from 7 randomized trials included in our sub-study. There was no difference in the risk of cesarean delivery between women with labor induction (21/148, 14.2%) and spontaneous labor (79/364, 21.7%) (odds ratio (OR) 0.60, 95% CI, 0.35-1.01; p=0.052). Among 274 women who used LMWH prophylaxis during pregnancy, the risk of cesarean delivery was lower among those that underwent labor induction (9.8%) compared to spontaneous labor (22.4%) (OR 0.38, 95% CI, 0.17-0.84; p=0.01). Conclusions: The risk of cesarean delivery is not increased after labor induction among a higher risk patient population with prior pregnancy complications. Our results suggest that women who receive LMWH during pregnancy might benefit from labor induction.

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“…По поводу этих факторов существуют разные мнения. Одни авторы возраст рожениц старше 35 лет и первые роды [6,7] относят к факторам риска, а другие как раз свидетельствуют об отсутствии связи возраста и наличия родов в анамнезе с риском оперативных родов [8].…”

Section: результаты исследования и их обсуждениеunclassified

Risk Factors of Caesarean Section in Women With Severe Preeclampsia

Bektemir¹,

Ryskeldieva²

2019

IJAFR (МЖПФИ)

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Определяли частоту и факторы риска кесарева сечения у женщин в доношенном сроке беременности с преэклампсией тяжелой степени. Проведено проспективное нерандомизированное исследование с участием 343 беременных, у которых на основании некоторых социально-демографических, анамнестических и клинико-лабораторных характеристик с использованием метода построения и анализа однофакторных и многофакторных логистических моделей регрессии были выявлены факторы риска возникновения необходимости кесарева сечения во время попытки родов через естественные родовые пути. Частота успешных вагинальных родов у женщин, находящихся в стабильном состоянии, с преэклампсией тяжелой степени составляет 79,0 %, а необходимость кесарева сечения возникает в 21,0 % случаев. Установлено, что при использовании индукции самый высокий риск кесарева сечения прогнозируется в группе беременных, роды которых были индуцированы динопростоном (p < 0,001), ОШ = 7,2 (95 % ДИ 3,6-14,6) и менее высокийпри использовании мизопростола (p = 0,05), ОШ = 2,0 (95 % ДИ 1,0-4,2) по сравнению с пациентками с самопроизвольно начавшимися родами. Риск кесарева сечения повышается при отсутствии дородового наблюдения беременных ОШ = 0,52 (95 % ДИ 0,30-0,93) и при наличии у них хронических воспалительных заболеваний почек ОШ = 2,4 (95 % ДИ 1,2-4,6) (при стандартизации по другим факторам риска). В качестве метода индукции родов при тяжелой преэклампсии следует отдавать предпочтение пероральному приему мизопростола. Следует активизировать работу семейных врачей в странах с низким уровнем дохода для улучшения качества дородового наблюдения. Необходимы дополнительные исследования, которые бы уточнили показания и противопоказания к вагинальным родам у женщин с тяжелой преэклампсией и заболеваниями почек. Ключевые слова: преэклампсия тяжелой степени, кесарево сечение, факторы риска, вагинальные роды RISK FACTORS OF CAESAREAN SECTION IN WOMEN WITH SEVERE PREECLAMPSIA Bektemir kyzy Zarema, Ryskeldieva V.T.

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Success of labor induction for pre-eclampsia at preterm and term gestational ages

Abstract: The majority of women with pre-eclampsia who undergo IOL achieve vaginal birth, even at early GAs.

Cited by 12 publications

References 14 publications

Risk Factors and Maternal-Fetal Outcomes of Pregnant with Preeclampsia Who Converted to Cesarean Section After A Trial Vaginal Birth

Risk Factors and Maternal-Fetal Outcomes of Pregnant with Preeclampsia Who Converted to Cesarean Section After A Trial Vaginal Birth

The risk of cesarean delivery after labor induction among women with prior pregnancy complications: A subgroup analysis of the AFFIRM study

Risk Factors of Caesarean Section in Women With Severe Preeclampsia

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