Induction Of Labour Increases Risk of Amniotic of Amniotic-Fluid Embolism

Oct 20, 2006

A Canadian population-based cohort study has revealed that medical induction of labour increases the risk of amniotic-fluid embolism. The study was led by Dr. Michael Kramer, Canadian Institutes of Health Research (CIHR) Senior Investigator from McGill University, and will be published in the October 21st issue of The Lancet.

Amniotic-fluid embolism (AFE) is a rare, but serious and even fatal maternal complication of delivery. While its cause is unknown, it is one of the leading causes of maternal mortality in developed countries, accounting for seven of 44 direct maternal deaths in Canada in the period 1997-2000.

This population-based study examined the association of AFE and medical induction of labour in a cohort of three million hospital births in Canada, for the twelve fiscal years 1991-2002.

“AFE remains a rare occurrence,” said Dr. Michael Kramer, principal investigator of the study and Scientific Director of CIHR’s Institute of Human Development, Child and Youth Health. “Of the 180 cases of AFE we found, 24 or 13% were fatal. AFE arose almost twice as frequently in women who had medical induction of labour as in those who did not; fatal cases arose 31⁄2 times more frequently.”

“Dr. Kramer's research has resulted in a discovery that will benefit physicians who look after pregnant women as they will now be aware of this potential complication should they induce labour", said Dr. Joseph Shuster, Interim Scientific Director of the MUHC. "This is an example of how academic university teaching hospitals improve the quality of patient care.”

The research team also found several other factors to be associated with higher rates of AFE, including multiple pregnancy, older maternal age (35 years or older), caesarean or instrumental vaginal delivery, eclampsia (a serious complication of pregnancy characterised by convulsions), polyhydramnios (too much amniotic fluid), abnormal placental position or separation, and cervical laceration or uterine rupture.

“Our findings confirm the hypothesis that medical induction of labour is related to an increased risk of AFE,” added Dr. Kramer. “Although the absolute risk increase of AFE for women is very small (four or five total cases and one or two fatal cases per 100,000 women induced) and is unlikely to affect the decision to induce labour in the presence of compelling clinical indications, women and physicians should be aware of this risk if the decision is elective.”

Dr. Kramer worked with Drs. K.S. Joseph and Thomas F. Baskett at Dalhousie University as well as with Mr. Jocelyn Rouleau at the Public Health Agency of Canada (PHAC). The research was conducted for the Maternal Health Study Group of the Canadian Perinatal Surveillance System, a program under PHAC auspices.

Source: Canadian Institutes of Health Research

Explore further: New guidelines for reproductive and developmental toxicity testing of oligonucleotide drugs

add to favorites email to friend print save as pdf

Related Stories

New study finds oceans arrived early to Earth

18 minutes ago

Earth is known as the Blue Planet because of its oceans, which cover more than 70 percent of the planet's surface and are home to the world's greatest diversity of life. While water is essential for life ...

Magma pancakes beneath Lake Toba

19 minutes ago

Where do the tremendous amounts of material that are ejected to from huge volcanic calderas during super-eruptions actually originate?

Does it help conservation to put a price on nature?

19 minutes ago

Putting a price on the services which a particular ecosystem provides may encourage the adoption of greener policies, but it may come at the price of biodiversity conservation. Writing today in the journal ...

Science casts light on sex in the orchard

19 minutes ago

Persimmons are among the small club of plants with separate sexes—individual trees are either male or female. Now scientists at the University of California, Davis, and Kyoto University in Japan have discovered ...

Recommended for you

New molecule sneaks medicines across the blood/brain barrier

2 hours ago

Delivering life-saving drugs across the blood-brain barrier (BBB) might become a little easier thanks to a new report published in the November 2014 issue of The FASEB Journal. In the report, scientists describe an antibo ...

Clock gene dysregulation may explain overactive bladder

2 hours ago

If you think sleep problems and bladder problems are a fact of life in old age, you may be right. A new report appearing in the November 2014 issue of The FASEB Journal, shows that our sleep-wake cycles are genetically connec ...

User comments : 0

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.