Details

Autor(en) / Beteiligte

• Nicholson, James M., MD, MSCE
• Parry, Samuel, MD
• Caughey, Aaron B., MD PhD
• Rosen, Sarah, MD
• Keen, Allison, MD
• Macones, George A., MD, MSCE

Titel

The impact of the active management of risk in pregnancy at term on birth outcomes: a randomized clinical trial

Ist Teil von

• American journal of obstetrics and gynecology, 2008-05, Vol.198 (5), p.511.e1-511.e15

Ort / Verlag

Philadelphia, PA: Mosby, Inc

Erscheinungsjahr

2008

Link zum Volltext

Quelle

MEDLINE

Beschreibungen/Notizen

• Objective The purpose of this study was to compare birth outcomes that result from the active management of risk in pregnancy at term (AMOR-IPAT) to those outcomes that result from standard management. Study Design This was a randomized clinical trial with 270 women of mixed parity. AMOR-IPAT used preventive labor induction to ensure delivery before the end of an estimated optimal time of delivery. Rates of 4 adverse obstetric events and 2 composite measures were used to evaluate birth outcomes. Results The AMOR-IPAT–exposed group had a similar cesarean delivery rate (10.3% vs 14.9%; P = .25), but a lower neonatal intensive care unit admission rate (1.5% vs 6.7%; P = .03), a higher uncomplicated vaginal birth rate (73.5% vs 62.8%; P = .046), and a lower mean Adverse Outcome Index score (1.4 vs 8.6; P = .03). Conclusion AMOR-IPAT exposure improved the pattern of birth outcomes. Larger randomized clinical trials are needed to explore further the impact of AMOR-IPAT on birth outcomes and to determine the best methods of preventive labor induction.