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Created on : 16 Mar 2007
Modified on : 15 Aug 2018

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Bibliographical entry (without author) :

Postterm with favorable cervix: is induction necessary ? {Thailande} Eur J Obstet Gynecol Reprod Biol. 2003 Feb 10;106(2):154-7.

Author(s) :

Chanrachakul B, Herabutya Y.

Year of publication :


URL(s) :…

Résumé (français)  :

Abstract (English)  :

OBJECTIVE: To study the cesarean rate between expectant management and immediate induction in the otherwise uncomplicated postterm pregnancy with favorable cervix.

STUDY DESIGN: A total of 249 women with uncomplicated pregnancies at 41 weeks plus 3 days (290 days) with favorable cervix (Bishop score > or =6) were randomized to either expectant management (n=125) or immediate induction of labor (n=124). The women in the induction group were sent to labor ward for induction by artificial rupture of membranes (ARM) and/or oxytocin infusion. The women with expectant management had nonstress test (NST) and amniotic fluid index (AFI) performed once a week and twice a week after 43 weeks of gestation until spontaneous labor.

RESULTS: The cesarean rate was not different between expectant management and immediate induction (21.6% versus 26.6%; P=0.36). Ninety-five percent of the expectant group delivered within 1 week after enrollment, and all of them delivered within 9 days after randomization. Maternal and fetal complications in both groups were not different. There was also no difference in the mean birth weight (P=0.24) and the frequency of macrosomia (birth weight > or = 4000 g) between the two groups (P=0.23).

CONCLUSION: Cesarean section rate between expectant management and immediate induction in the otherwise uncomplicated postterm pregnancy with favorable cervix was not different. Due to the very low adverse perinatal outcome, both expectant management and immediate induction are acceptable.

Sumário (português)  :

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Argument (français) :

RCT. Aucun avantage ni désavantage particulier à déclencher à 41 SA + 3j sur col favorable plutôt que d’attendre en surveillant. Important : la quasi totalité des femmes du groupe expectative avaient accouché dans la semaine suivante.

Argument (English):

Argumento (português):

Keywords :

➡ c-section/caesarean ; induction of labor ; guidelines ; post-term pregnancy

Author of this record :

Cécile Loup — 16 Mar 2007
➡ latest update : Bernard Bel — 15 Aug 2018

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#2069   Savas M. Menticoglou, Philip F. Hall (2002). Routine induction of labour at 41 weeks of gestation: nonsensus consensus. BJOG, 2002 May;109(5): 485-491 ➡
#2067   Bréart G, Goujard J, Maillard F, Chavigny C, Rumeau-Rouquette C, Sureau C. (1982). Comparaison de deux attitudes obstétricales vis-à-vis du déclenchement artificiel du travail à terme. Essai randomisé. J Gynecol Obstet Biol Reprod (Paris). 1982;11(1):107-112. ➡
#2018   Roach VJ, Rogers MS. (1997). Pregnancy outcome beyond 41 weeks gestation. {Chine}. Int J Gynaecol Obstet. 1997 Oct;59(1):19-24. ➡
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Discussion (display only in English)
15 Aug 2018 12:44[FR] Cette étude porte sur 249 femmes à 41 semaines d’aménorrhée. Le tirage au sort en a placé 124 dans le groupe « déclenchement » et 125 dans le groupe « surveillance ». Les déclenchements ayant été réalisés le jour même du tirage au sort, aucune femme n’a accouché spontanément avant l’intervention. Le résultat est un taux de césariennes de 27% pour le groupe « déclenchement » et 22% pour le groupe « surveillance ». Bien que ces taux soient significativement différents, avec un risque accru après déclenchement, le résumé affirme : « The cesarean rate was not different between expectant management and immediate induction ».
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Bernard Bel
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