Does timing of labor induction in women with chronic hypertension affect the risk of cesarean delivery?

This study investigated if labor induction decreases the risk of preeclampsia or cesarean delivery in women with high blood pressure (hypertension). They found that labor induction at 38 weeks may prevent the risk of complications during delivery in these women.

Hypertension can increase the risk of complications during labor. Complications include pre-eclampsia (dangerously high blood pressure). It can also lead to still-birth. Pregnant women that experience hypertension during their pregnancy, are advised to have an induction of labor. This is for the safety of both the mother and baby. It is typically carried out in the 38^th or 39^th week of pregnancy.

Induction of labor is usually performed in women with chronic (long-term) hypertension. Some evidence suggests that induction increases or decreases the risk of cesarean delivery. Cesarean delivery is a serious surgical operation.

This study included 2,420 pregnant women with chronic hypertension. The authors examined the medical records of women who underwent an induction at 38 or 39 weeks pregnant. This was compared to the records of women that gave birth at 39 weeks or later.

Women that were not induced at 38/39 weeks had an increased risk of pre-eclampsia (19-19.2%). Women that had an induction at 38 weeks had a 26% lower risk of cesarean delivery compared to those who were not induced. Babies born via induction at 39 weeks had a 51% lower risk of death due to respiratory (breathing) problems. Most women that did not undergo induction at 38 (56.8%) and 39 (57.8%) weeks later underwent an induction.

The authors concluded that labor induction at 38-39 weeks may improve the risk of complications due to hypertension during delivery.

Some important information was not available for analysis. Details such as ethnicity and the severity of hypertension could influence these results.

If you have any concerns regarding hypertension and pregnancy, please consult with your doctor.