The Australian & New Zealand journal of obstetrics & gynaecology · 2022
Five-year trends in induction of labour in a large Australian metropolitan maternity service.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
O' Sullivan Caoimhe, Wilson Erin, Beckmann Michael
Аннотация
BACKGROUND: The World Health Organisation recommends that induction of labour (IOL) be performed only with a clear medical indication. Australian rates of IOL appear to be rising, with more than one-third of women having labour induced. This may reflect changing clinician and consumer perceptions of the benefits and potential harms of term IOL.
AIMS: To understand recent trends in the rates and indications for IOL.
MATERIALS AND METHODS: A retrospective cohort study was undertaken in a Level 6 maternity facility, in metropolitan South-East Queensland, Australia. Routinely collected data were gathered between 2015 and 2020. Exclusion criteria were multiple pregnancies, stillbirth and pre-labour rupture of membranes. Pre-labour rupture of membranes was excluded due to inability to assess if IOL for this indication was a true induction or augmentation of labour. Indications for induction were grouped into maternal, fetal, elective indications, 'post-dates' and decreased fetal movements (DFM). Rates of IOL and frequency of the various indications were compared over time.
RESULTS: About 46 530 livebirths occurred during the study period, with labour induced in 31.7%. The proportion of women undergoing IOL increased from 29.8% in 2015 to 33.4% in 2019 (P < 0.001). The proportion of inductions for DFM and elective indications increased over time, with a substantial decrease in 'post-dates' IOL.
CONCLUSIONS: This large contemporary analysis of IOL trends in Australia has demonstrated rising rates and changing indications for IOL. There remain large knowledge gaps in areas such as care of women with DFM, definitions and management of 'post-term pregnancy', and the economic and service impacts of rising trends in the rate of IOL.
AIMS: To understand recent trends in the rates and indications for IOL.
MATERIALS AND METHODS: A retrospective cohort study was undertaken in a Level 6 maternity facility, in metropolitan South-East Queensland, Australia. Routinely collected data were gathered between 2015 and 2020. Exclusion criteria were multiple pregnancies, stillbirth and pre-labour rupture of membranes. Pre-labour rupture of membranes was excluded due to inability to assess if IOL for this indication was a true induction or augmentation of labour. Indications for induction were grouped into maternal, fetal, elective indications, 'post-dates' and decreased fetal movements (DFM). Rates of IOL and frequency of the various indications were compared over time.
RESULTS: About 46 530 livebirths occurred during the study period, with labour induced in 31.7%. The proportion of women undergoing IOL increased from 29.8% in 2015 to 33.4% in 2019 (P < 0.001). The proportion of inductions for DFM and elective indications increased over time, with a substantial decrease in 'post-dates' IOL.
CONCLUSIONS: This large contemporary analysis of IOL trends in Australia has demonstrated rising rates and changing indications for IOL. There remain large knowledge gaps in areas such as care of women with DFM, definitions and management of 'post-term pregnancy', and the economic and service impacts of rising trends in the rate of IOL.