Wednesday, October 27, 2021

New NICE guidance recommends inducing women in labour earlier

Draft guidelines published by the UK’s National Institute for Health and Care Excellence (NICE) has recommended inducing women in labour earlier in order to ‘make birth safer’.

The draft guidance includes updated recommendations which bolster previous advice in light of new evidence on induction timings, NICE said in a statement.

The updated guideline recommends women with uncomplicated, singleton pregnancies should now be offered induction at 41 weeks, stating that the induction should occur ‘as soon as possible’.

Previously, NICE guidelines had recommended induction between 41 and 42 weeks and that women who choose not to be induced should be monitored after 42 weeks.

The update comes following recent research comparing induction times, with outcomes showing higher infant mortality after 42 weeks if a woman had not been induced.

A NICE independent advisory guideline committee also recommended that more research should be undertaken to establish at which gestational age induction should be offered to women who are more at risk of adverse outcomes if their pregnancy continues.

Another major update to the guideline involves new recommendations for women who have experienced intrauterine foetal death.

NICE’s committee identified an increased risk for women who experience this and who have previously had a caesarean birth, adding that they are more likely to suffer uterine rupture.

The draft guidance recommends women with this risk be advised when discussing their birth options.

Previously, advice had recommended that women with this risk should be offered pharmacological interventions to induce labour, although the committee found no evidence about any of these interventions in this group.

In addition, the committee recommended research into the best methods for inducing labour in women who experience intrauterine foetal death and who have had a previous caesarean birth.

“It’s vitally important that pregnant women faced with the possibility of induced labour are offered advice based on the latest evidence,” said Paul Chrisp, director of the Centre for Guidelines at NICE.

“By advising induced labour one week earlier, we can help ensure that women and babies are safer from harm and have the best possible outcomes during birth,” he added.

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