Preeclampsia and mode of delivery: an evaluation of cases submitted to labor induction

• Grant number: 23/13456-4
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Effective date (Start): December 01, 2023
• Effective date (End): November 30, 2024
• Field of knowledge: Health Sciences - Medicine - Maternal and Child Health
• Principal Investigator: Maria Laura Costa do Nascimento
• Grantee: Ana Julia Ganzeli Oliveira
• Host Institution: Centro de Atenção Integral à Saúde da Mulher (CAISM). Hospital da Mulher Professor Doutor José Aristodemo Pinotti. Universidade Estadual de Campinas (UNICAMP). Campinas , SP, Brazil

Abstract

Background: Preeclampsia (PE) is one of the most significant causes of maternal-fetal morbidity/mortality worldwide, defined as arterial hypertension after 20 weeks of gestation, with the presence of proteinuria and/or target-organ involvement. The management of the disease involves deciding on the best time of delivery. PE is not an indication for cesarean section and, whenever possible, if adequate maternal and fetal vitality, induction of labor should be implemented. Understanding the factors associated with successful induction and evaluating the associated maternal and perinatal outcomes is important to support possible future interventions to safely reduce cesarean rates. Objective: To evaluate the mode of delivery in cases of PE, the frequency of induction of labor; and to investigate the factors associated with the success of labor induction. Methods and data analysis: This is an observational, retrospective study, through the review of electronic medical records of approximately 520 women hospitalized with a diagnosis of PE in the period of 42 months (estimate considering the previous reported prevalence of PE in the institution of 7% and the total of 7411 deliveries in the period). PE cases will be identified through the International Code of Diseases (ICD) of hospitalization and/or hospital discharge. The sociodemographic characteristics of the cases of PE, clinical and obstetric background, and maternal and perinatal outcomes will be described. The cases submitted to induction of labor will be evaluated and compared with the cases submitted to cesarean section (by means of the chi-square test or Fisher's Exact, making use of the software Epi-Info 7® and SPSS® v8.0). Furthermore, a logistic regression analysis will be performed to investigate factors independently associated with the success of induction (vaginal childbirth).