Induction at 41 weeks increases the risk of caesarean section in a hospital with a low rate of caesarean sections.

Abstract

OBJECTIVE:

To analyse the impact of a change in the management of prolonged pregnancies from inducing labour at 42(+0) to induction at 41(0-6).

DESIGN:

Retrospective cohort study.

METHODS:

Analysis of 3563 single pregnancies with cephalic presentation of ≥ 41 weeks of gestation delivered in Cruces University Hospital (Spain). Two cohorts were compared corresponding to before and after the change in the policy on induction.

MAIN OUTCOME MEASURES:

Induction rate, vaginal delivery rate, newborn morbidity and mortality.

RESULTS:

The overall rate of caesarean sections in the patients included in the study was 12.8% (19.5% among those induced and 8.4% among those in whom the onset of labour has been spontaneous). The caesarean section rate in cohorts 41(0-6) and 42(+0) were 14.1% and 11.4%, respectively (p=0.01). Though there were more newborns with umbilical cord blood ph<7.10 in cohort 41(0-6) than in the other group (8.7% versus 4.5%; p<0.01), no significant differences were found between cohorts in 5-min Apgar score < 7, number of admissions to the neonatal care unit or perinatal mortality.

CONCLUSION:

The induction of labour during week 41 in prolonged pregnancies may increase the rate of caesarean sections in hospitals with low rates of caesarean sections.

• Authors: Jorge Burgos, Leire Rodríguez, Borja Otero, Patricia Cobos, Carmen Osuna, María del Mar Centeno, Juan Carlos Melchor, Luis Fernández-Llebrez, Txantón Martínez-Astorquiza
• Journal: The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians (J Matern Fetal Neonatal Med) Vol. 25 Issue 9 Pg. 1716-8 (Sep 2012) ISSN: 1476-4954 [Electronic] England
• PMID: 22339273 (Publication Type: Evaluation Study, Journal Article)

Topics

• Adult
• Cesarean Section (statistics & numerical data)
• Cohort Studies
• Female
• Gestational Age
• Hospitals, Maternity (statistics & numerical data)
• Humans
• Incidence
• Infant Mortality
• Infant, Newborn
• Labor, Induced (adverse effects, statistics & numerical data)
• Obstetric Labor Complications (epidemiology, etiology, mortality, surgery)
• Pregnancy
• Pregnancy, Prolonged (epidemiology, mortality, therapy)
• Retrospective Studies
• Risk Factors
• Spain (epidemiology)
• Stillbirth (epidemiology)
• Young Adult