Ist die Geburtseinleitung bei intrauteriner Wachstumsrestriktion und small-for-gestational-age-Feten problematisch? Eine historische Kohortenstudie

Zusammenfassung

Ziel Die Datenlage zu Geburtseinleitungen bei einem small-for-gestational-age Fetus (SGA-Fetus) oder einer intrauterinen Wachstumsrestriktion (IUGR) ist limitiert, sodass das Ziel dieser Untersuchung war, Geburtseinleitungen bei SGA-/IUGR-Feten mit Geburtseinleitungen bei Schwangerschaften mit einem fetalen Schätzgewicht oberhalb der 10. Perzentile zu vergleichen.

Material und Methodik In diese multizentrische Kohortenstudie wurden Einlingsschwangerschaften am Termin eingeschlossen. Geburtseinleitungen bei SGA-/IUGR-Feten (IUGR-Gruppe) wurden mit Geburtseinleitungen bei Feten mit einem fetalen Schätzgewicht oberhalb der 10. Perzentile (Kontrollgruppe) verglichen. Der primäre Zielparameter war die Kaiserschnitt-Rate.

Ergebnisse Es gab keinen Unterschied bezüglich der Kaiserschnitt-Rate zwischen den beiden Gruppen (27,0 vs. 26,2%, p=0,9154). In der IUGR-Gruppe lag jedoch häufiger ein pathologisches CTG (30,8  vs. 21,9%, p=0,0214) vor, und es wurden mehr Fetalblutanalysen (2,5 vs. 0,5%, p=0,0261) durchgeführt. Die Rate an kindlichen Verlegungen in die Kinderklinik war ebenfalls in der IUGR-Gruppe höher (40,0 vs. 12,8%, p<0,0001).

Schlussfolgerung Geburtseinleitungen bei wachstumsrestringierten Feten sind nicht mit einer höheren Rate an Kaiserschnitten assoziiert.

Abstract

Purpose Induction of labour for small-for-gestational-age (SGA) foetus or intrauterine growth restriction (IUGR) is common, but data are limited. The aim of this trial was therefore to compare labour induction for SGA/IUGR with cases with normal fetal growth beyond the 10^th percentile.

Material and methods This historical multicentre cohort study included singleton pregnancies at term. Labour induction for SGA/IUGR (IUGR group) was compared with cases of fetal growth beyond the 10^th percentile (control group). Primary outcome measure was caesarean section rate.

Results The caesarean section rate was not different between the 2 groups (27.0 vs. 26.2%, p=0.9154). In the IUGR group, abnormal CTG was more common (30.8 vs. 21.9%, p=0.0214), and fetal blood analyses were conducted more often (2.5 vs. 0.5%, p=0.0261). There were more postpartum transfers to the NICU in the IUGR group (40.0 vs. 12.8%, p<0.0001), too.

Conclusion Induction of labour for fetal growth restriction was not associated with an increased rate of caesarean section.

Schlüsselwörter

Geburtseinleitung - IUGR - fetale Wachstumsrestriktion - SGA - Kaiserschnitt

Key words

labour induction - IUGR - fetal growth restriction - sga - caesarean section

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