Dr. Wennerholm highlights future opportunities for managing prolonged pregnancy

In a recent interview with Contemporary OB/GYN, Ulla-Britt Wennerholm, MD, a medical doctor and professor of obstetrics at Sahlgrenska University Hospital in Gothenburg, Sweden, discussed the management of prolonged pregnancies, particularly focusing on the use of active labor and induction.

Wennerholm emphasized the importance of balancing the risks and benefits when offering induction or active management to patients, stating that each decision should be individualized based on the patient’s circumstances. She also advocated for clear communication with the patient about potential risks, such as stillbirth, and the benefits of both methods. While the risks are typically small, the perception of these risks can vary from patient to patient. She highlighted the difference between induction and natural labor, mentioning that patients undergoing induction tend to have a longer stay at the hospital compared to those with spontaneous labor.

Wennerholm also addressed the need for further research to optimize the management of prolonged pregnancies. One critical area of research determining the optimal gestational age for inducing labor. She referred to international trials, such as those conducted in the United States and United Kingdom, which have explored starting labor induction as early as 39 weeks. Wennerholm noted that her own study found a small but significant increase in cesarean section rates with induction, particularly in pregnancies at 39 to 40 weeks, which were used as a reference group. She questioned whether this increase in cesarean sections is directly linked to induction or whether other factors, such as the COVID pandemic during the study period, may have influenced the results. The increase in cesarean section rates is a key point for future research to explore further.

Additionally, Wennerholm highlighted an ongoing study in Sweden that examines the safety and effectiveness of outpatient inductions. This study involves a randomized trial where patients can undergo cervical ripening at home before being induced, as opposed to the traditional hospital setting. She suggested that if the trial proves that outpatient induction is safe for both mother and baby, it could provide patients with a more positive and comfortable experience during the early stages of labor.

This video is part 2 of a 2-part series. Click here for part 1.