Worldwide, there has been a trend toward later motherhood. Concurrently, the incidence of subfertility has been on the rise, necessitating conception using assisted reproductive technologies (ARTs). These pregnancies are considered high risk due to fetal complications such as antepartum stillbirth and growth restriction and maternal complications such as increase in maternal morbidity and mortality. Early induction of labor can help to mitigate these risks. However, this has to be balanced against the iatrogenic harms of earlier delivery to both the baby, including respiratory distress and NICU stay, and the mother who might experience longer labor and other complications such as uterine hyperstimulation. Induction of labor at 39 weeks is the optimal timing for preventing antepartum stillbirth and avoiding iatrogenic harm. Delivery by elective cesarean section is not advocated as its benefits in these patients are unclear compared with the short- and long-term complications of a major abdominal surgery.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.bpobgyn.2021.08.007 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Severe pregnancy-associated atypical hemolytic uremia syndrome in the context of the COVID-19 pandemic: a novel survival case report.
BMC Pregnancy Childbirth
January 2025
Department of Intensive Care Medicine, Army Medical Center of PLA, No. 10 Changjiang Road, Yuzhong District, Chongqing, 400010, People's Republic of China.
Background: Pregnancy-associated atypical hemolytic uremic syndrome (aHUS) is a form of thrombotic microangiopathy (TMA) caused by uncontrolled activation of the complement system during pregnancy or the postpartum period. In the intensive care unit, aHUS must be differentiated from sepsis-related multiple organ dysfunction, thrombotic thrombocytopenic purpura (TTP), hemolysis, elevated liver enzymes, and low platelet (HELLP) syndrome. Early recognition of aHUS is critical for effective treatment and improved prognosis.
View Article and Find Full Text PDFImpact of epidural analgesia on outcomes of vaginal birth after cesarean delivery.
Arch Gynecol Obstet
January 2025
Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Primary Objective: To assess the association between Epidural Analgesia (EA) during Vaginal Birth After Cesarean (VBAC) and delivery mode (spontaneous or instrumental vaginal delivery). Secondary objectives include maternal and neonatal outcomes.
Methods: In this retrospective population-based cohort study, all women who underwent a VBAC with and without EA, between the years 1996-2016 at the Soroka University Medical Center (SUMC) were included.
Investigating the implementation of a Trial of Labour After Caesarean (TOLAC) delivery bundle with respect to decreasing caesarean delivery rates: a multisite quality improvement initiative.
BMJ Open
January 2025
Department of Obstetrics and Gynecology, University of Toronto, Toronto, Ontario, Canada.
Objectives: To study the effect of implementing a Trial of Labour After Caesarean (TOLAC) delivery bundle with respect to decreasing caesarean delivery rates across five hospitals.
Design: Prospective quality improvement study.
Setting: Five Canadian hospital sites participated, two academic centres and three community hospitals, with annual delivery rates ranging from 2500 to 7500 per site.
Clinical outcomes and feasibility of implementing outpatient labor induction with misoprostol: A prospective cohort study.
Acta Obstet Gynecol Scand
January 2025
Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway.
Introduction: In response to the increasing rates of induction of labor (IOL), outpatient IOL has emerged as a potential approach to enhance women's satisfaction while reducing costs and staffing requirements. There is a growing interest in oral misoprostol as an outpatient IOL method, particularly in the Nordic region. This study aims to evaluate the clinical outcomes and feasibility of implementing IOL with oral misoprostol as an outpatient procedure.
View Article and Find Full Text PDFLabor onset and delivery mode in women with congenital heart disease-A nationwide cohort study.
Acta Obstet Gynecol Scand
January 2025
Department of Heart Disease, Haukeland University Hospital, Bergen, Norway.
Introduction: More women with congenital heart disease (CHD) are pursuing pregnancy. Their cardiac condition may impact the pregnancy and necessitate interventions during childbirth. We aimed to investigate labor onset and delivery mode in women with CHD relative to women without heart disease and explore the time trends of induced labor and cesarean deliveries.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!