Duinen, E.C.G. van Esther Catharina Gerarda (2015) Verschillen in maternale en neonatale morbiditeit bij inductie van de baring ten tijde van verschillende termijnen, bij zwangerschapsgeïnduceerde hypertensie. thesis, Medicine.
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Abstract
Background. Hypertensive disorders during pregnancy are one of the main causes of maternal mortality. In the Isala every pregnancy complicated by pregnancy induced hypertension (PIH) is induced at 37 weeks’ gestation, or later if the disease presents itself after 37 weeks’ gestation. This advice is partially based on the HYPITATstudy. However, in this study outcomes at different gestational ages and for PIH in particular were not analysed. The goal of this study is to critically analyse the current advice to induce labour at 37 weeks’ gestation in cases of mild PIH, by comparing outcomes of induction at other gestational ages with those found at 37 weeks’ gestation. Material and methods. This study is a retrospective descriptive study. The study population exists of patients who had PIH and induction of labour after 37 weeks’ gestation. According to gestational age at time of labour, the study population has been divided into groups. For every variable the outcomes at 37 weeks’ gestation have been compared with those found at other gestational ages. The outcomes at other gestational ages have also been compared among each other. The primary outcomes are maternal and neonatal morbidity, defined as the presence of several possible complications. Secondary outcomes are maternal and neonatal mortality. Results. In total 574 patients were included. Neonates born at 37 weeks’ gestation were significant more frequently admitted to the pediatric ward, compared to neonates born at 38 and 39 weeks’ gestation. At the gestational age of 41 weeks and later we saw a significant increase of maternal complications. However, because of the study design the maternal results turned out to be unreliable. Conclusion. Induction of labour at 37 weeks’ gestation leads to a significant higher risk of neonatal hospitalization and neonatal morbidity. In the available literature there are no objections found against watchful waiting till 38 or 39 weeks’ gestation. In conclusion, based on this study it’s beneficial for the neonate to induce labour at 38 or 39 weeks’ gestation, with no proven elevated risk for the mother. The advice, based on this study is to induce labour at 38 weeks’ gestation in cases of mild PIH, because of the lower risk of neonatal hospitalization.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Nij Bijvank, Drs. S.W.A. and Gynaecologie en obstetrie and Isala, te Zwolle |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:46 |
| Last Modified: | 25 Jun 2020 10:46 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/719 |
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