Tag Archives: Induction

NIHR Signal: Induction of labour may be considered in pregnant women with a large baby

NIHR
Image Source: NIHR

Induction of labour does not increase the risk of caesarean delivery in pregnant women with a larger than average baby.

This is based on a review of four trials of 1190 women with a suspected large baby who were allocated either to have labour induced from 38 weeks or to watchful waiting.

Induction did not increase the risk of most negative outcomes for the baby, such as bleeding in the brain, or mother, such as major tearing. However, these outcomes are rare, so a larger number of women would need to be studied to be confident in these findings. When mothers were not induced babies were larger and born about a week later than if they were induced. They did suffer from more fractures, which can be a complication of delivering a larger baby.

Current guidance recommends only offering induction at 41 or 42 weeks in otherwise healthy women who have a larger than average baby.

This analysis suggests that earlier induction is likely to be safe and may be an option for women to consider.

Read the whole review here

NIHR Signal: Induction of labour within 24 hours, if waters break at 37 weeks of pregnancy, can reduce womb infection

Newborn_infant_by_Bonnie_Gruenberg
Image Source: Wikimedia

Inducing labour may halve the risk of infection in the womb when waters break from 37 weeks. The procedure was started within 24 hours and was compared to waiting for labour to start on its own.

Waters breaking at full term without the onset of labour is called pre-labour rupture of membranes. This can increase risks of maternal and neonatal infection and the need for caesarean section. As most women deliver spontaneously within a day, NICE recommend that women are offered an informed choice of either induction 24 hours after premature rupture of membranes or to watch and wait.

This updated Cochrane review included new evidence and suggests that induction before 24 hours may reduce infections without increasing caesarean sections, but there remains some uncertainty. This is due to low study quality, lack of longer term outcomes, and too few participants in trials to compare the numbers of any rare serious events.

These findings may help inform shared decisions about induction by providing more information to help women understand the risks.

Read the full Signal here