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Labor induction after fetal death. A retrospective analysis
Sharon M Salamat1, Helain J Landy, Mary J O'Sullivan
1Division of Maternal-Fetal Medicine (R-136), Department of Obstetrics and Gynecology, University of Miami School of Medicine, 1611 NW 12th Avenue, Miami, FL 33136, USA. ssalamat@med.miami.edu
The Journal of Reproductive Medicine
|February 13, 2002
Summary
Labor induction for stillborn infants is safe, potentially reducing maternal infection rates. While induction may prolong delivery unit stays, it does not increase postpartum hemorrhage risks compared to spontaneous labor.
Area of Science:
- Obstetrics and Gynecology
- Perinatal Medicine
- Maternal-Fetal Medicine
Background:
- Fetal death presents complex management decisions for obstetricians.
- Historically, awaiting spontaneous labor was common practice after fetal demise.
- Evidence comparing outcomes of labor induction versus spontaneous labor in these cases is limited.
Purpose of the Study:
- To compare delivery outcomes in patients with stillborn infants.
- To evaluate maternal morbidity following labor induction versus spontaneous labor onset.
Main Methods:
- Retrospective chart review of singleton pregnancies with fetal death over three years.
- Exclusion of patients with multiple prior cesarean deliveries, placenta previa, preeclampsia, or suspected abruptio placentae.
- Analysis of delivery unit time, maternal hemorrhagic morbidity, and endomyometritis rates.
Main Results:
- 100 patients underwent labor induction; 108 had spontaneous labor onset.
- Labor induction was associated with longer delivery unit stays (13.7 vs. 4.4 hours).
- Endomyometritis rates were higher in the spontaneous labor group (6% vs. 1%); no differences in hemorrhage or transfusion needs.
Conclusions:
- Labor induction following fetal death diagnosis is a safe management option.
- Induction may be associated with a reduced risk of maternal infectious morbidity.