Does Routine Induction of Labour at 41 Weeks Really Reduce the Rate of Caesarean Section Compared With Expectant Management?

Pavicic, Heidi; Hamelin, Kathy; Menticoglou, Savas

doi:10.1016/s1701-2163(16)34241-4

Cited by 6 publications

(2 citation statements)

References 22 publications

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“…Studies that used retrospective methods to compare induction of labor to spontaneous onset of labor report an increased risk of cesarean among women who were induced 38‐47 . However, in studies where induction of labor is compared with expectant management, a decreased risk of cesarean has been found among women who had their labor induced in some 48‐55 but not all studies 56‐58 . Some randomized controlled trials 59,60 that compared planned induction of labor with expectant management found that mothers who had a routine induction of labor at 39 weeks' gestation were less likely to deliver by cesarean.…”

Section: Discussionmentioning

confidence: 99%

A cascade of interventions: A classification tree analysis of the determinants of primary cesareans in Australian public hospitals

Fox

Topp

Lindsay

et al. 2021

Birth

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Background Both globally and in Australia, there has been a sharp rise in cesarean births (CB). Commonly, this rise has been attributed to the changing epidemiology of women giving birth. A significant body of knowledge exists on the risk factors associated with a greater need for cesarean. Yet, we have little information on the reasons recorded by clinicians as to why cesareans are provided. This study aimed to explore the drivers of primary cesareans in Australian public hospitals. Methods Using a linked administrative data set, the frequency and percent of mothers’ characteristics were compared between those who had a cesarean birth and those who had a vaginal birth (n = 98 967) with no history of previous cesareans in Queensland public hospitals between July 1, 2012, and June 30, 2015. The top 10 reasons recorded by clinicians for a primary cesarean were reported. Using a machine‐learning algorithm, two decision trees were built to determine factors driving primary cesarean birth. Results “Labour and delivery complicated by fetal heart rate anomaly” (23%) and “primary inadequate contractions” (22.8%) were the top two reasons for a primary cesarean birth. The most common characteristics among mothers who had fetal heart rate anomalies were as follows: artificial rupture of membranes (39%), oxytocin (32%), no obstruction of labor (42%), and epidural (52%). For women who had primary inadequate contractions, the most common characteristics were as follows: epidural (33%), oxytocin (49%), artificial rupture of membranes (45%), and fetal stress (56%). Conclusions Efforts should be made by health practitioners during the antenatal period to maximize the use of preventative measures that minimize the need for medical interventions.

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Section: Discussionmentioning

confidence: 99%

A cascade of interventions: A classification tree analysis of the determinants of primary cesareans in Australian public hospitals

Fox

Topp

Lindsay

et al. 2021

Birth

View full text Add to dashboard Cite

show abstract

“…Similarly, one large cohort study from Sweden, on nulliparous women, reported a threefold increase in cesarean section, while in another study an increase in cesarean rate of 25.4% in induced women as compared with 16.6% in women was shown with spontaneous onset of labor. 9,10 The results yielded by comparison of elective induction of labor with spontaneous labor are neither clinically relevant nor useful for prospective counseling of women as the control group was not representative.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of Elective Induction of Labor Compared with Expectant Management in Nulliparous Women with Unfavorable Cervix

Begum¹,

Samal²

2018

Journal of South Asian Federation of Obstetrics and Gynaecology

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Objectives: The purpose of this study was to test the association between elective induction of labor and cesarean delivery and to determine maternal and neonatal outcomes in elective induction of labor. Materials and methods:We conducted a retrospective matched cohort study in a tertiary care hospital from January 2014 to December 2015, among 182 nulliparous women at gestational age of 39 0/7 weeks or more who had single live pregnancy with known cervical status of ≤5 at 38 0/7 to 38 6/7 weeks and were managed either by elective induction or expectant management. Data were compared using χ 2 and Student's t-test, and p < 0.05 was considered significant. Results:The cesarean delivery rate was 51% in expectant and 46.8% in elective induction group, which was not much different. Women who were electively induced spent more time in labor delivery unit (14 hours, 21 minutes vs 12 hours, 45 minutes, p < 0.01), had labor longer than 12 hours (50 vs 36.5%, p = 0.05), received more frequently oxytocin (63.5 vs 47.9%, p = 0.03), and were more likely to deliver during daytime between 6.00 am and 6.00 pm (64.5 vs 52%, p = 0.07) compared with expectant group. There were no difference with regard to obstetric events and maternal neonatal outcomes. Conclusion:Elective induction did not result in increased risk of cesarean delivery in nulliparous women with unfavorable cervix. It is relatively safe as we had observed no evidence of any other increased adverse maternal or neonatal outcomes with elective induction.

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Induction of labour with unfavourable local conditions for suspected fetal growth restriction after 36 weeks of gestation: Factors associated with the risk of caesarean

Pinton

Tomzack

Merckelbagh

et al. 2021

Journal of Gynecology Obstetrics and Human Reproduction

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Does Routine Induction of Labour at 41 Weeks Really Reduce the Rate of Caesarean Section Compared With Expectant Management?

Cited by 6 publications

References 22 publications

A cascade of interventions: A classification tree analysis of the determinants of primary cesareans in Australian public hospitals

A cascade of interventions: A classification tree analysis of the determinants of primary cesareans in Australian public hospitals

Outcomes of Elective Induction of Labor Compared with Expectant Management in Nulliparous Women with Unfavorable Cervix

Induction of labour with unfavourable local conditions for suspected fetal growth restriction after 36 weeks of gestation: Factors associated with the risk of caesarean

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