Induction of labour for suspected macrosomia at term in non-diabetic women: a systematic review and meta-analysis of randomized controlled trials.
Publication/Presentation Date
2-1-2017
Abstract
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.
Volume
124
Issue
3
First Page
414
Last Page
421
ISSN
1471-0528
Published In/Presented At
Magro-Malosso, E. R., Saccone, G., Chen, M., Navathe, R., Di Tommaso, M., & Berghella, V. (2017). Induction of labour for suspected macrosomia at term in non-diabetic women: a systematic review and meta-analysis of randomized controlled trials. BJOG : an international journal of obstetrics and gynaecology, 124(3), 414–421. https://doi.org/10.1111/1471-0528.14435
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
27921380
Department(s)
Administration and Leadership
Document Type
Article