Induced labour may help risky pregnancy

According to a new study, labour should be induced after 37 weeks in pregnant women who have preganancy-related hypertension or mild pre-eclampsia (raised blood pressure with presence of protein in the urine).

Researchers studied 756 pregnant women in Netherlands who had been pregnant 36 to 41 weeks and had gestational hypertension or mild pre-eclampsia to investigate whether induction of labour in women with a singleton pregnancy reduces severe maternal morbidity. The participants were divided into two groups - one group of women underwent induced labour while the second group was monitored as the participant's pregnancies continued.

The two groups were compared on several measures that the researchers labeled as poor maternal outcome, including death, eclampsia (the occurrence of seizures), pulmonary edema (fluid in the lungs), progression to severe high blood pressure, major post-birth bleeding (loss of a litre or more of blood), and what's known as HELLP syndrome (hemolytic anaemia, elevated liver enzymes and low platelet count).

It was found that 31 percent of the women who had induced labour and 44 percent of the women who were monitored had poor maternal outcome. For women who had induced labour, that equated to a 29 percent lower risk for developing poor maternal outcome than those who were monitored. Also, the women who had induced labour had fewer cesarean sections than those in the monitored group.

The findings support the association of induction of labour with a reduced risk of severe hypertension or HELLP syndrome and subsequent need for cesarean section emphasising the importance of frequent blood pressure monitoring during the last few weeks of pregnancy.

The researchers concluded that induction of labour should be advised for women with gestational hypertension and a diastolic blood pressure of 95 mmHg or higher or mild preeclampsia at a gestational age beyond 37 weeks.