Melbourne researchers have found that one of two common methods of inducing labor is safer for babies, although both were equally safe for the mother and neither resulted in more caesareans.
The findings could help inform the growing number of inductions carried out globally each year – now around 14 million – when the risks of continued pregnancy outweigh the benefits.
Published in The Lancetthe study, led by Monash Health and Monash University, found clear evidence that a balloon catheter leads to a better safety profile for newborns than vaginal hormones.
This includes fewer side effects such as acidosis (a build-up of acid in the bloodstream), poor condition after birth or admission to the neonatal intensive care unit. There was no difference in maternal adverse events or caesarean section rates between the two procedures.
Induction of labor is one of the most common obstetric procedures, and rates have increased significantly over the past decade, from 25 to 35% in Australia alone.
Most commonly, the cervix is ”ripened” either mechanically, by inserting a water-filled balloon catheter that applies pressure to the cervix for several hours and guides it open, or hormonally, with drugs that replicate prostaglandin, a hormone that also softens and opens the cervix.
The international data analysis concluded that although both methods were effective, balloons were safer for newborns and their use could significantly reduce the adverse effects of childbirth.
Investigators of 12 high-quality trials contributed data, which included 5,460 women who were randomized in the original trials to either a catheter or intravaginal prostaglandins.
First author Dr. Madeleine Jones, Monash Health/Monash Women’s Registrar and Monash University Department of Obstetrics and Gynecology Ph.D. candidate, said previous studies have shown that balloon catheters are likely to be as effective as intravaginal prostaglandins.
“However, it was unclear whether one approach was safer than the other, as there is limited ability to measure them using either single clinical trials or analysis of pooled data from multiple trials,” said Dr. Jones said.
“We established an international collaboration led by our research team at Monash University and Monash Health to address this knowledge gap. This allowed us to achieve clear and important results.”
Senior author Dr. Wentao Li, a researcher in Monash University’s Department of Obstetrics and Gynaecology, said the findings were significant.
“For the first time, we found clear evidence that transvaginal prostaglandin catheterization leads to an improved safety profile for neonates, including fewer adverse events such as acidosis, poor postpartum condition, or NICU admission,” said Dr. . . . Lee said.
“Maternal adverse events showed no difference between the two methods, nor was there a significant difference in cesarean section rates.”
“What it all means is that the safety of labor should be carefully considered in shared decision-making and policy-making regarding the choice of methods of delivery.
Madeleine N Jones et al., Catheters versus intravaginal prostaglandins for induction of labor (CPI Collaborative): individual participant data analysis of randomized controlled trials, The Lancet (2022). DOI: 10.1016/S0140-6736(22)01845-1
Provided by Monash University
Quotation: Balloon labor induction safer for babies, researchers find (2022, November 11) Retrieved November 11, 2022 from https://medicalxpress.com/news/2022-11-balloon-labor-induction-safer-babies.html
This document is subject to copyright. Except for reasonable communications for the purpose of private research or investigation, no part may be reproduced without written permission. The material is provided for informational purposes only.