We will discuss “Perinatal outcomes following an earlier post-term labour induction policy: a historical cohort study” by Hedegaard and co-workers from 24 June 2015 for 7 days.
*This paper will be made FREE-TO-VIEW on 11 June 2015.
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Start date: 24 June 2015 (the discussion will open for 7 days between 24 June to 1 July)
First hosted discussion session(s) starts at: GMT 7pm (UK time)
The Blue Journal Club is an international journal club on women’s health research based on Twitter (as @BlueJCHost). We start our conversation on the last Wednesday of every month and use the hashtag #BlueJC for our tweets. Simply add this hashtag (“#BlueJC”) to each tweet and we will capture it. Each #BlueJC opens for 7 days with an advertised start time. All BJOG #BlueJC papers also have complementary slide sets suitable for face-to-face journal clubs with your local colleagues. You can access the slide set of this paper here.
The discussion points are attached below (quoted from the published manuscript)
A 38-year-old white woman comes to see you at 37 weeks of gestation in her first pregnancy. She has read in the news that ‘inducing babies at 37 weeks cuts risks of child dying or developing a serious health condition such as cerebral palsy’ (dailym.ai/1Bpwtir). She has an uncomplicated pregnancy and no other medical history. She asks for your advice about the timing of delivery and the possibility of induction of labour. How would you counsel her?
Description of research
All babies born at or after 37 weeks of gestation in Denmark between 2000 and 2012
Implementation of a proactive labour induction practice recommended by Danish clinical guidelines since 2009
Outcomes before the implementation of the new guideline (prior to 2009)
Umbillical cord pH < 7.0; Apgar score < 7 at 5 minutes; neonatal death; admission to a neonatal intensive care unit (NICU); cerebral palsy; fetal weight < 4500 g; shoulder dystocia; peripheral nerve injury
A historical cohort study
- Do you routinely offer induction of labour to women similar to the scenario? If yes, when do you recommend delivery?
- The Danish guidelines recommend induction of labour between 41+3 and 41+5 weeks of gestation. How does this recommendation compare with your local practice?
- What are the advantages and pitfalls of using a historical cohort study to address this research question?
- How did the authors address the study limitations in their methods?
- Can you briefly summarise the results of this study as a take-home message of one sentence?
- Has the general media accurately reported the results of this study? (See an example at dailym.ai/1Bpwtir)
- Would the results of this study influence your management of the woman in the scenario?
- How would the results of this study influence your daily practice?
Jauniaux E, Kilby M. All twins should be delivered before 38 weeks of gestation: FOR. BJOG 2014;121:1292.
Saugstad OD. Twins should be delivered before 38 weeks of gestation: AGAINST. BJOG. 2014 Sep;121(10):1293.
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