Back to Search
Start Over
Induction of Labor Versus Expectant Monitoring for Gestational Hypertension or Mild Preeclampsia After 36 Weeks' Gestation (HYPITAT): A Multicentre, Open-Label Randomized Controlled Trial EDITORIAL COMMENT
- Source :
- Obstetrical & Gynecological Survey, 64(12), 776-778. LIPPINCOTT WILLIAMS & WILKINS, Obstetrical & gynecological survey, 64(12), 776-778. Lippincott Williams and Wilkins
- Publication Year :
- 2009
-
Abstract
- Although induction of labor in pregnant women at term with gestational hypertension or mild preeclampsia is already recommended and practiced in the United States and other developed countries, no randomized clinical trials have been carried out comparing induction of labor versus expectant monitoring. This multicenter, parallel, randomized, unblinded controlled trial compared the effect of labor induction or expectant management on maternal morbidity in singleton women with gestational hypertension or mild preeclampsia at term. A total of 776 women were randomized to undergo induction of labor (n = 377) or expectant monitoring (n = 379). The study was conducted between 2005 and 2008 at 38 hospitals in the Netherlands. The primary outcome measure was a composite of adverse maternal outcomes: maternal mortality, maternal morbidity (eclampsia, HELLP syndrome, pulmonary edema, thromboembolic disease, or placental abruption), progression to severe disease or proteinuria, and major postpartum hemorrhage (blood loss of more than 1000 mL within 24 hour of delivery). Data were analyzed according to an intention-to-treat basis. The composite adverse primary outcome occurred in fewer women who were induced compared to those receiving expectant monitoring (31% [117/377] vs. 44% [166/379]; the relative risk was 0.71, with a 95% confidence interval of 0.59-0.86, P < 0.0001). No fetal or neonatal deaths or cases of eclampsia or placental abruption occurred in either group. The investigators conclude from these findings that women with mild hypertensive disease beyond 37 weeks' gestation should be advised to undergo induction.
- Subjects :
- Gestational hypertension
Pregnancy
medicine.medical_specialty
Eclampsia
Placental abruption
Obstetrics
HELLP syndrome
business.industry
medicine.medical_treatment
Obstetrics and Gynecology
Gestational age
General Medicine
medicine.disease
law.invention
Randomized controlled trial
law
Labor induction
medicine
business
reproductive and urinary physiology
Subjects
Details
- Language :
- English
- ISSN :
- 00297828
- Volume :
- 64
- Issue :
- 12
- Database :
- OpenAIRE
- Journal :
- Obstetrical & gynecological survey
- Accession number :
- edsair.doi.dedup.....9488ec98ae516d0be98839dbb24f8def