Induction vs expectant management in IUGR at term

January 01, 0001

Induction vs expectant management in IUGR at term

These Dutch researchers compared labor induction with expectant monitoring in near term (beyond 36 weeks) pregnancies with intrauterine growth restriction (IUGR) via the DIGITAT multicentre randomized equivalence trial (Disproportionate Intrauterine Growth Intervention Trial At Term). The trial used intention to treat methodology.

The researchers report: "321 pregnant women were randomly allocated to induction and 329 to expectant monitoring. Induction group infants were delivered 10 days earlier (mean difference -9.9 days) and weighed 130 g less (mean difference -130 g) than babies in the expectant monitoring group. A total of 17 (5.3%) infants in the induction group experienced the composite adverse neonatal outcome, compared with 20 (6.1%) in the expectant monitoring group (difference -0.8%). Caesarean sections were performed on 45 (14.0%) mothers in the induction group and 45 (13.7%) in the expectant monitoring group (difference 0.3%)."

The researchers concluded: "In women with suspected IUGR at term, we found no important differences in adverse outcomes between induction of labour and expectant monitoring. Patients who are keen on non-intervention can safely choose expectant management with intensive maternal and fetal monitoring. However, it is rational to choose induction to prevent possible neonatal morbidity and stillbirth."

There appears to be no difference in outcomes with expectant management and labor induction in near term pregnancies with IUGR.

For the full abstract, click here.

BMJ 341:c7087, 21 December 2011 © 2010 BMJ Publishing Group Ltd.
Induction versus expectant monitoring for intrauterine growth restriction at term: randomised equivalence trial (DIGITAT). K E Boers, S M C Vijgen, D Bijlenga, et al. Correspondence to K E Boers: [email protected]

Category: W. Pregnancy, Family Planning. Keywords: intrauterine growth restriction, IUGR, term, induction, monitoring, randomized equivalence trial, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 18 March 201

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.

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