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Should cervical favourability play a role in the decision for labour induction in gestational hypertension or mild pre-eclampsia at term? An exploratory analysis of the HYPITAT trial
- Source :
- BJOG, 119(9), 1123-1130. Wiley-Blackwell, Bjog-an International Journal of Obstetrics and Gynaecology, 119(9), 1123-1130. Wiley, BJOG-an International Journal Of Obstetrics And Gynaecology, 119(9), 1123-1130. Wiley, Tajik, P, van der Tuuk, K, Koopmans, C M, Groen, H, van Pampus, M G, van den Berg, P P, van der Post, J A, van Loon, A J, de Groot, C J M, Kwee, A, Huisjes, A J M, van Beek, E, Papatsonis, D N M, Bloemenkamp, K W M, Unnik, G A, Porath, M, Rijnders, R J, Stigter, R H, de Boer, K, Scheepers, H C, Zwinderman, A H, Bossuyt, P M & Mol, B W 2012, ' Should cervical favourability play a role in the decision for labour induction in gestational hypertension or mild pre-eclampsia at term? An exploratory analysis of the HYPITAT trial ', BJOG: An International Journal of Obstetrics & Gynaecology, vol. 119, no. 9, pp. 1123-1130 . https://doi.org/10.1111/j.1471-0528.2012.03405.x, BJOG: An International Journal of Obstetrics and Gynaecology, 119(9), 1123-1130, Bjog, BJOG: An International Journal of Obstetrics & Gynaecology, 119(9), 1123-1130. Wiley Online Library, BJOG : an International Journal of Obstetrics and Gynaecology, 119, 9, pp. 1123-30, BJOG : an International Journal of Obstetrics and Gynaecology, 119, 1123-30
- Publication Year :
- 2012
- Publisher :
- Wiley, 2012.
-
Abstract
- Please cite this paper as: Tajik P, van der Tuuk K, Koopmans C, Groen H, van Pampus M, van der Berg P, van der Post J, van Loon A, de Groot C, Kwee A, Huisjes A, van Beek E, Papatsonis D, Bloemenkamp K, van Unnik G, Porath M, Rijnders R, Stigter R, de Boer K, Scheepers H, Zwinderman A, Bossuyt P, Mol B. Should cervical favourability play a role in the decision for labour induction in gestational hypertension or mild pre-eclampsia at term? An exploratory analysis of the HYPITAT trial. BJOG 2012;119:11231130. Objective To examine whether cervical favourability (measured by cervical length and the Bishop score) should inform obstetricians decision regarding labour induction for women with gestational hypertension or mild pre-eclampsia at term. Design A post hoc analysis of the Hypertension and Pre-eclampsia Intervention Trial At Term (HYPITAT). Setting Obstetric departments of six university and 32 teaching and district hospitals in the Netherlands. Population A total of 756 women diagnosed with gestational hypertension or pre-eclampsia between 36 + 0 and 41 + 0 weeks of gestation randomly allocated to induction of labour or expectant management. Methods Data were analysed using logistic regression modelling. Main outcome measures The occurrence of a high-risk maternal situation defined as either maternal complications or progression to severe disease. Secondary outcomes were caesarean delivery and adverse neonatal outcomes. Results The superiority of labour induction in preventing high-risk situations in women with gestational hypertension or mild pre-eclampsia at term varied significantly according to cervical favourability. In women who were managed expectantly, the longer the cervix the higher the risk of developing maternal high-risk situations, whereas in women in whom labour was induced, cervical length was not associated with a higher probability of maternal high-risk situations (test of interaction P = 0.03). Similarly, the beneficial effect of labour induction on reducing the caesarean section rate was stronger in women with an unfavourable cervix. Conclusion Against widely held opinion, our exploratory analysis showed that women with gestational hypertension or mild pre-eclampsia at term who have an unfavourable cervix benefited more from labour induction than other women. Trial registration The trial has been registered in the clinical trial register as ISRCTN08132825.
- Subjects :
- Gestational hypertension
Pregnancy, High-Risk
medicine.medical_treatment
law.invention
Randomized controlled trial
law
reproductive and urinary physiology
expectant management
RISK
education.field_of_study
Obstetrics
CESAREAN DELIVERY
Pregnancy Outcome
Obstetrics and Gynecology
Gestational age
Bishop score
female genital diseases and pregnancy complications
medicine.anatomical_structure
PREGNANCY
Female
Adult
medicine.medical_specialty
induction of labour
pre-eclampsia
Decision Making
Population
Maternal Medicine
Gestational Age
medicine
MANAGEMENT
gestational hypertension
Humans
Caesarean section
Labor, Induced
education
Cervix
Gynecology
Pregnancy
Cesarean Section
business.industry
NULLIPAROUS WOMEN
Hypertension, Pregnancy-Induced
Delivery, Obstetric
medicine.disease
cervical length
ELECTIVE INDUCTION
Quality of hospital and integrated care [NCEBP 4]
business
Cervical Ripening
Subjects
Details
- Language :
- English
- ISSN :
- 14710528, 14700328, and 11231130
- Volume :
- 119
- Issue :
- 9
- Database :
- OpenAIRE
- Journal :
- Bjog-an International Journal of Obstetrics and Gynaecology
- Accession number :
- edsair.doi.dedup.....0d4742d560406fe39e142c28d857d2ca