August 5, 2009

Induction of Labor Recommended for Women With High Blood Pressure

Inducing a pregnancy at 37 weeks, may be healthier for some women and their babies.

About six percent of pregnancies are affected by gestational hypertension, also known as high blood pressure, mild preeclampsia, and other hypertensive disorders. A recent HYPITAT study, found women with these disorders should have their labor induced once they reach 37 weeks, in an effort to reduce death in mother or baby.

The study looked at 756 pregnant women in The Netherlands. All of the expectant mothers were between 36 to 41 weeks and were pregnant with only one fetus. In addition, all of the women were either experiencing high blood pressure or mild preeclampsia. The women were put into two groups, either the induced labor group, or expectant monitoring group. Researchers discovered women who were induced had a 29 percent lower risk of developing poor maternal outcomes, such as bleeding, severe high blood pressure, or death, than those who had expectant monitoring. Women in the induction group were also found to need fewer caesarean sections, than those in the expectant monitoring group. This additional finding is important because women with previous caesarean section are at increased risk of developing a uterus scar rupture in a future pregnancy, in addition to higher caesarean risks in the future.

"The results of our trial are important for both developed countries in which induction of labor in women with hypertensive disease beyond 36 weeks' gestation has been controversial, and for developing countries in which maternal morbidity and motility rates are substantially increased. Our finding that induction of labor was associated with a reduced risk of severe hypertension and subsequent reduced need for caesarean section, emphasized the importance of frequent blood pressure monitoring during the concluding weeks of pregnancy," Dr. Corine M. Koopmans, Departments of Obstetrics and Gynecology, University Medical Centre Groningen, Netherlands, and colleagues, were quoted saying.

SOURCE: The Lancet, August 2009