A NEW STUDY has revealed that inducing labour in women at high-risk of caesarean section may actually be beneficial, contradicting earlier studies suggesting a relationship between induction and caesarean rates.
The study, published today in BJOG: An International Journal of Obstetrics and Gynaecology, reviews clinical trials on induction to look at how it affects the risk of caesareans in women with intact membranes, where the amniotic sac has not yet ruptured.
Rising C-section rates across North America and Europe continue to be a major concern for medical professionals and one factor that provides conflicting evidence and advice is induction of labour.
Of the 37 trials analysed, 27 included uncomplicated pregnancies over 37 weeks of gestation and ten covered pregnancies that were complicated with diabetes, suspected macrosomia, twins or at a high risk score for caesarean section. Researchers compared differences in caesarean rates between use of induction and expectant management, which involves close monitoring of a pregnant woman with complications until symptoms appear.
Only three trials documented statistically significant differences in rates between the two methods, two reported reductions with one reporting an increase in risk.
While the remaining trials reported non-significant differences in caesarean section rates, based on further analysis of the combined results the researchers suggest the overall caesarean section risk was lower by approximately 17 per cent with induction of labour.
The authors concluded that further clinical trials are needed to look at elective induction for women at a high risk of caesarean section.
“Induction of labour is one of the most common interventions in obstetrics and it is widely held that limiting induction will reduce caesarean section rates,” said co-author, Stephen Wood. “Our analysis suggests that this may not be the case.”
“However, it should be noted that the differences in caesarean section risk may have occurred due to factors other than induction and that more trials are needed to address whether labour induction would benefit women at high risk for caesarean section such as older or obese mothers.”
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