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Z Geburtshilfe Neonatol 2019; 223(01): 33-39
DOI: 10.1055/a-0664-9135
Originalarbeit
© Georg Thieme Verlag KG Stuttgart · New York

Geburtseinleitung bei Erstgebärenden ab errechnetem Termin in einem Niedrigrisiko-Kollektiv

Induction of Labour in Nulliparous Women Beyond Term in a Low-Risk Population
Jutta Pretscher
1   Frauenklinik, Universitätsklinikum Erlangen, Erlangen
,
Christel Weiss
2   Medizinische Statistik, Biomathematik und Informationsverarbeitung, Universitätsmedizin Mannheim, Mannheim
,
Ulf Dammer
1   Frauenklinik, Universitätsklinikum Erlangen, Erlangen
,
Florian Stumpfe
1   Frauenklinik, Universitätsklinikum Erlangen, Erlangen
,
Florian Faschingbauer
1   Frauenklinik, Universitätsklinikum Erlangen, Erlangen
,
Matthias W. Beckmann
1   Frauenklinik, Universitätsklinikum Erlangen, Erlangen
,
Sven Kehl
1   Frauenklinik, Universitätsklinikum Erlangen, Erlangen
› Author Affiliations
Further Information

Publication History

eingereicht 23 March 2018

angenommen nach Überarbeitung15 July 2018

Publication Date:
05 September 2018 (online)

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Zusammenfassung

Ziel Ziel dieser Arbeit war es zu untersuchen, ob die Rate an Entbindungen per Sectio caesarea nach Geburtseinleitung ab 40+0 SSW abhängig vom Gestationsalter ist.

Material und Methodik In dieser Kohortenstudie wurden Geburtseinleitungen in einem Niedrigrisikokollektiv zwischen 3 Gruppen (Gruppe 1: 40+0 – 40+6 SSW, Gruppe 2: 41+0 – 41+3 SSW, Gruppe 3:>41+3 SSW) verglichen. Der primäre Zielparameter war die Kaiserschnittrate.

Ergebnis Es zeigte sich kein signifkanter Unterschied hinsichtlich des primären Zielparameters Kaiserschnittrate zwischen den Gruppen 1–3 (p=0,4036). Auch in der multivariablen Analyse waren die Gruppenzuteilung und damit das Gestationsalter nicht relevant. Zu den Faktoren, die die Kaiserschnittrate beeinflussten, gehörten der maternale BMI (p<0,0001), das maternale Alter (p=0,0005) und das Geburtsgewicht (p=0,0151). Bei den sekundären Outcomeparametern wie dem pH- und dem Apgar-Wert sowie der Rate an postpartaler Verlegung in die Kinderklinik zeigten sich ebenfalls keine signifikanten Unterschiede zwischen den Gruppen.

Schlussfolgerung Der Zeitpunkt der Geburtseinleitung ab 40+0 SSW hatte in dem Niedrigrisikokollektiv keinen Einfluss auf die Kaiserschnittrate.

Abstract

Purpose To evaluate the influence of gestational age on induction of labour in nulliparous women.

Material and methods This historical cohort study analyzed inductions of labour in low-risk nulliparous women. Therefore the collective was divided into 3 groups (group 1: 40+0 to 40+6 weeks of gestation, group 2: 41+0 to 41+3 weeks of gestation, group 3:>41+3 weeks of gestation). The primary outcome measure was the caesarean section rate.

Results The caesarean section rate was not different among the 3 groups (p=0.4036). The impact of gestational age on induction in multivariable analysis was not significant. Maternal BMI (p<0.0001), maternal age (p=0.0005) and birth weight (p=0.0151) had an influence on the caesarean section rate. Regarding the secondary outcome measures such as umbilical cord blood pH, Apgar score and postpartal neonatal intensive care unit admission, no statistically significant differences have been revealed among the groups.

Conclusion Timing of labour induction after 40+0 weeks of gestation in a low-risk population of nulliparous women did not influence the caesarean section rate.

Schlüsselwörter

Geburtseinleitung - Kaiserschnitt - Terminüberschreitung - Erstgebärende - Niedrigrisiko

Key words

induction of labour - caesarean section - postterm pregnancy - nulliparous - low risk

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