The alternative method is known as Active Management of Risk in Pregnancy at Term, or AMOR-IPAT, for short. AMOR-IPAT uses “risk-based preventative labour induction to ensure that each pregnant woman enters labour at a gestational age that maximizes her chance for vaginal delivery,” says lead researcher, James M. Nicholson, MD, Assistant Professor of Family Medicine and Community Health at Penn.
“Over the past decade, the rates of cesarean delivery have climbed above 30 percent”, says Nicholson. “Cesarean delivery is associated with higher rates of postpartum hemorrhage, major postpartum infection and hospital readmission,” he adds.
The study included 270 women who were recruited when they were between 32 and 37,5 weeks into their pregnancy. Women who remained undelivered at 37 weeks four days of gestation were randomized to either AMOR-IPAT or usual care. Three facilities within the University of Pennsylvania Health System recruited women, including the Hospital of the University of Pennsylvania Obstetrics Clinic, the Pennsylvania Hospital Obstetrics Clinic, and Penn Family Care.
Risk factors for the AMOR-IPAT exposed group were identified and categorized as either interfering with placental growth or accelerating fetal growth. Each of these factors is associated with a published odds ratio for cesarean delivery, which, in turn, is used to determine the optimal time of delivery. If a woman in the exposed group did not experience spontaneous labour as she approached the end of this time frame, preventative labour induction was scheduled.
In the AMOR-IPAT group, the greater the number and severity of risk factors, the earlier preventative labour induction was offered within the term period (38 – 41 weeks of gestation). The findings of this study suggest that the AMOR-IPAT approach to obstetric risk lead to healthier babies and better birth outcomes for mothers.
MEDICA.de; Source: University of Pennsylvania School of Medicine