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C 6: I . L Spontaneous labour, though sometimes inconvenient, advantages. Labour induction is considered when of earlier birth outweigh the risks of labour induction, taking into account the condition (‘inducibility’) of the mother’s uterine cervix. One of the most common reasons for is prolonged pregnancy (see page 144). indications for labour induction☺ PLANNED EARLY BIRTH VERSUS EXPECTANT MANAGEMENT.(WAITING) FOR PRELABOUR RUPTURE OF MEMBRANES (37 WEEKS OR MORE): reduced maternal infections ICU admissions. (Dare MR, Middleton P, Crowther CA,.Flenady VJ, Varatharaju B) CD005302 (in RHL 11).BACKGROUND: Prelabour rupture of membranes at term is managedexpectantly or by elective birth, but it is not clear if waiting for birth spontaneously is better than interveningOBJECTIVES: To assess the effects of planned early birth versus expectant management for women with term prelabour rupture of fetal, infant and maternal wellbeingMETHODS: Standard PCG methods (see page xvii). Search date:.November 2004MAIN RESULTS: 12 trials (total of 6814 women) were included. was generally induction with oxytocin or prostaglandin, trial using homoeopathic caulophyllum. Overall, no differences for mode of birth between planned and expectant groups: relative risk (RR) of caesarean section , 95% confidence interval (CI) (12 trials, 6814 women); RR of operative vaginal birth , 95%. to (seven trials, 5511 women). Significantly fewer women in Cochrane Pocketbook: Pregnancy and Childbirth . Hofmeyr et alCopyright © 2008, Z. Alfiervic, C. A. Crowther, L. Duley, A. M. Gulmezoglu, G. ML. Gyte ,.E. D. Hodnett, G. J. Hofmeyr, J. P. NeilsonCHAPTER 6INDUCTION OF LABOUR . compared with expectant management groups had chorioamnionitis (RR , 95% CI to ; nine trials, 6611 women) or endometritis (RR , 95% CI to ; four trials, 445 women). No seen for neonatal infection (RR , 95% CI to ; nine trials,.6406 infants). However, fewer infants under planned management went intensive or special care compared with expectant management.(RR , 95% CI to , number needed to treat 20; five trials, ). In a single trial, significantly more women with planned management viewed their care more positively than those expectantly managed.(RR of ‘nothing liked’ , 95% CI to ; 5031 women)AUTHORS’ CONCLUSIONS : Planned management (with methodssuch as oxytocin or prostaglandin) reduces the risk of some maternal infectious morbidity without increasing caesarean sections vaginal births. Fewer infants went to neonatal under planned management although no differences were neonatal infection rates. Since planned and expectant management may not be very different, women need to have to make informed choicesPLANNED EARLY BIRTH VERSUS EXPECTANT MANAGEMENT WITH PRETERM PRELABOUR RUPTURE OF 34 TO 37 WEEKS’ GESTATION FOR IMPROVING : (Buchanan SL, Crowther CA, Morris J) Protocol [see ] BACKGROUND: Preterm prelabour rupture of the membranes.(PPROM) occurs when there is rupture of the membranes prior to prior to the onset of labour. The clinician has to consider the potential risks and benefits of induction of labour against expectant management until term or complications arise which necessitate deliveryOBJECTIVES: To assess the effect of planned early birth versus for women with preterm prelabour rupture of the membranes between 34 and 37 weeks’ gestation for fetal, infant and maternal FOR INDUCTION OF LABOUR TO IN THE SECOND OR THIRD TRIMESTER FOR A FETAL ANO

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