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Induced Labor Tied to Maternal Risk

Women With Drug-Induced Labor at Twice the Risk for Rare but Often Fatal Complication
WebMD Health News
Reviewed by Louise Chang, MD

Oct. 19, 2006 -- Drug-induced labor increases the risk for a very rare -- but often fatal -- delivery complication known as amniotic-fluid embolism, a new study confirms.

Researchers in Canada concluded that labor induction doubles a woman's risk for developing the complication, which is a leading cause of delivery-related maternal death.

About one in five births in the U.S. involves medical induction, and the researchers believe the practice may be responsible for as many as 40 cases of amniotic-fluid embolism and 15 deaths each year in this country.

Inductions Increasing

Labor induction is often medically necessary, such as when the baby is full-term and continuing the pregnancypregnancy presents a risk to either mother or baby.

But labor induction is also increasingly performed when there is no medical reason for it, usually for the convenience of either the physician or the parents-to-be.

Michael S. Kramer, MD, one of the study's researchers, says anyone considering elective labor induction should be aware of the risk.

"This finding should give people pause when they are contemplating an induction that is not medically indicated," he tells WebMD. "This complication is very rare, but it is also very serious."

Risk of Fatal Embolisms

The causes of amniotic-fluid embolism are not well understood.

The condition occurs with little warning during or shortly after delivery, when amniotic fluid enters the mother's bloodstream, causing life-threatening respiratory distress, a drop in blood pressure, and shock.

In an effort to get a better idea of who is most at risk for the condition, Kramer and colleagues at Montreal's McGill University and the Canadian Institute of Health Research examined more than 3 million Canadian hospital deliveries performed between 1991 and 2002.

The researchers identified 180 cases of amniotic-fluid embolism, 24 of them fatal. That equaled six cases per 100,000 deliveries, and just under one death per 100,000 deliveries.

The researchers found that overall risk for an embolism was twice as high among women whose labors were medically induced.

The risk of a fatal embolism was 3 1/2 times higher among women who had induced labors than among those who did not.

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