Induction of labour for suspected macrosomia at term in non-diabetic women : a systematic review and meta-analysis of randomized controlled trials
© 2016 Royal College of Obstetricians and Gynaecologists..
BACKGROUND: Several randomized controlled trials (RCTs) compared induction of labour with expectant management in non-diabetic women with suspected fetal macrosomia.
OBJECTIVE: To evaluate the effects of labour induction for suspected fetal macrosomia.
SEARCH STRATEGY: Literature search in electronic databases.
SELECTION CRITERIA: We included all RCTs of suspected fetal macrosomia comparing labour induction with expectant management in term pregnancy.
DATA COLLECTION AND ANALYSIS: The primary outcome was the incidence of caesarean delivery.
MAIN RESULTS: Four RCTs, including 1190 non-diabetic women with suspected fetal macrosomia at term, were analysed. Pooled data did not show a significant difference in incidence of caesarean delivery [relative risk (RR) 0.91, 95% confidence interval (CI) 0.76-1.09], operative and spontaneous vaginal delivery, shoulder dystocia, intracranial haemorrhage, brachial plexus palsy, Apgar score <7 at 5 min, cord blood pH <7, and mean birth weight comparing women who received induction of labour with those who were managed expectantly. The induction group had a significantly lower time to delivery (mean difference -7.55 days, 95% CI -8.20 to -6.89), lower rate of birth weight ≥4000 g (RR 0.50, 95% CI 0.42-0.59) and ≥4500 g (RR 0.21, 95% CI 0.11-0.39), and lower incidence of fetal fractures (RR 0.17, 95% CI 0.03-0.79) compared with expectant management group.
CONCLUSION: Induction of labour ≥38 weeks for suspected fetal macrosomia is associated with a significant decrease in fetal fractures, and therefore can be considered as a reasonable option. TWEETABLE ABSTRACT: #Induction of labour for #macrosomia improves neonatal outcome.
| Errataetall: | |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2017 |
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| Erschienen: |
2017 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:124 |
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| Enthalten in: |
BJOG : an international journal of obstetrics and gynaecology - 124(2017), 3 vom: 22. Feb., Seite 414-421 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Magro-Malosso, E R [VerfasserIn] |
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| Links: |
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| Themen: |
Caesarean |
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| Anmerkungen: |
Date Completed 11.12.2018 Date Revised 18.09.2023 published: Print-Electronic CommentIn: BJOG. 2017 Feb;124(3):422. - PMID 27921388 Citation Status MEDLINE |
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| doi: |
10.1111/1471-0528.14435 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM266855296 |
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| 245 | 1 | 0 | |a Induction of labour for suspected macrosomia at term in non-diabetic women |b a systematic review and meta-analysis of randomized controlled trials |
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| 500 | |a Date Revised 18.09.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a CommentIn: BJOG. 2017 Feb;124(3):422. - PMID 27921388 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2016 Royal College of Obstetricians and Gynaecologists. | ||
| 520 | |a BACKGROUND: Several randomized controlled trials (RCTs) compared induction of labour with expectant management in non-diabetic women with suspected fetal macrosomia | ||
| 520 | |a OBJECTIVE: To evaluate the effects of labour induction for suspected fetal macrosomia | ||
| 520 | |a SEARCH STRATEGY: Literature search in electronic databases | ||
| 520 | |a SELECTION CRITERIA: We included all RCTs of suspected fetal macrosomia comparing labour induction with expectant management in term pregnancy | ||
| 520 | |a DATA COLLECTION AND ANALYSIS: The primary outcome was the incidence of caesarean delivery | ||
| 520 | |a MAIN RESULTS: Four RCTs, including 1190 non-diabetic women with suspected fetal macrosomia at term, were analysed. Pooled data did not show a significant difference in incidence of caesarean delivery [relative risk (RR) 0.91, 95% confidence interval (CI) 0.76-1.09], operative and spontaneous vaginal delivery, shoulder dystocia, intracranial haemorrhage, brachial plexus palsy, Apgar score <7 at 5 min, cord blood pH <7, and mean birth weight comparing women who received induction of labour with those who were managed expectantly. The induction group had a significantly lower time to delivery (mean difference -7.55 days, 95% CI -8.20 to -6.89), lower rate of birth weight ≥4000 g (RR 0.50, 95% CI 0.42-0.59) and ≥4500 g (RR 0.21, 95% CI 0.11-0.39), and lower incidence of fetal fractures (RR 0.17, 95% CI 0.03-0.79) compared with expectant management group | ||
| 520 | |a CONCLUSION: Induction of labour ≥38 weeks for suspected fetal macrosomia is associated with a significant decrease in fetal fractures, and therefore can be considered as a reasonable option. TWEETABLE ABSTRACT: #Induction of labour for #macrosomia improves neonatal outcome | ||
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| 700 | 1 | |a Di Tommaso, M |e verfasserin |4 aut | |
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