Inducing labor in women with preeclampsia at pregnancy end reduces complications

Inducing labor in women with preeclampsia at pregnancy end reduces complications and the number of high-risk situations for the mother. An analysis published in Ultrasound in Obstetrics & Gynecology evaluated the impact of the HYPITAT-I findings on timing of labor and subsequent outcomes for mother and child in the Netherlands.

In 2009, the Hypertension and Preeclampsia Intervention Trial At near Term-I (HYPITAT- I) trial showed that inducing labor in women with gestational hypertension or preeclampsia at the end of pregnancy reduces the number of high-risk situations for the mother, without compromising the health of newborns. The aim of the current study was to evaluate the impact of these findings on obstetric management and maternal and perinatal outcomes in The Netherlands.

Hypertensive disorders of pregnancy (HDP), such as gestational hypertension and pre‐eclampsia, complicate about 10% of gestations and are major contributors to maternal and neonatal morbidity and mortality. Despite extensive research efforts, the best treatment for Hypertensive disorders of pregnancy currently available is delivery of the placenta.

The analysis corroborated the results of the HYPITAT-I trial, concluding that inducing labor is the optimal management strategy. It showed that in the period after the HYPITAT-I trial, the rate of induction of labor at the end of pregnancy was increased in women with the hypertensive disease in the Netherlands. This might have contributed to benefits for both women and their newborns. There was also an increased incidence of emergency Cesarean section in both Hypertensive disorders of pregnancy and reference groups; however, this change was significantly greater in the reference than in the HDP group (P < 0.001 for the interaction).

Following the HYPITAT‐I trial, there was a higher rate of induction of labor and improved obstetric outcome in term pregnancies complicated by Hypertensive disorders of pregnancy in The Netherlands.

"With our impact analysis, we were able to evaluate whether expected results based on a randomized controlled trial were or could be reflected in daily care," said lead author Catherine de Sonnaville, of OLVG, in the Netherlands. "Also, this is the only way to reveal unintended effects resulting from the widespread adoption of interventions and therefore provides important information."

For more details click on the link: http://dx.doi.org/10.1002/uog.20417