| Titre : | Does the evidence support induction of labour at term for women of advanced maternal age? (2019) |
| Auteurs : | Alexandra Mclnnes |
| Type de document : | Article |
| Dans : | Midwifery Digest (Midirs) (Vol. 29, n° 2, June 2019) |
| Article en page(s) : | p. 197-202 |
| Langues: | Anglais |
| Descripteurs : |
HE Vinci Accouchement provoqué ; Age de la vie ; Grande-Bretagne ; Grossesse ; Risque |
| Résumé : |
Aim : The aim of this literature review is to assess whether the risks of advanced maternal age (AMA) outweigh the risks associated with induction of labour (IOL) and what the best practice is.
Method : A systematic literature review was performed and the findings critiqued and analysed. Results : Women of AMA are at higher risk of adverse pregnancy outcomes including stillbirth, caesarean section (CS), low birth weight and intrauterine growth restriction (IUGR). However, induction of labour (IOL) also carries a number of risks to women, which should be considered when deciding on time/method of delivery. The review also found that risks associated with AMA are greatly reduced if women are cared for in a midwifery-led environment instead of obstetric led. Furthermore, the increase in risk is different for women of different ages in the AMA group and for nulliparous women compared to multiparous women. Conclusion : IOL is necessary for some women of AMA if their risks are increased so that adverse outcomes may be avoided. However, the risks can differ for those aged 35 compared to those aged 45 and are dependent on parity, yet the current guidelines use the same care pathway for all women of AMA (National Institute for Health and Care Excellence (NICE) 2008, World Health Organization (WHO) 2014). Women of AMA who are otherwise low risk should be cared for in an alongside midwifery-led unit as outcomes are more positive and the risk of requiring medical interventions is greatly reduced.Nulliparous and multiparous women, even of the same age, should not be advised to have an IOL at the same gestation. Recommendations for future practice: The author has produced a range of graphs showing the possible real risks for woman of AMA, both nulliparous and multiparous and used them to create a pathway for individualised care of women of AMA. |
| Disponible en ligne : | Non |
Exemplaires (1)
| Cote | Support | Localisation | Section | Disponibilité |
|---|---|---|---|---|
| Midwifery Digest (Midirs). Vol. 29, n° 2 (June 2019) | Périodique papier | Woluwe | Espace revues | Consultation sur place uniquement Exclu du prêt |
