Long-Term Follow-Up of labor induction protocols for preeclampsia
DOI:
https://doi.org/10.5281/zenodo.22813874Keywords:
preeclampsia, labor induction, misoprostol, Foley catheter, long-term follow-upAbstract
Background: Labor induction is now used in a large share of pregnancies complicated by preeclampsia, yet long-term maternal and neonatal outcomes across different induction protocols remain incompletely characterized.
Objective: This retrospective cohort study compared long-term maternal and neonatal outcomes following labor induction with oxytocin, vaginal misoprostol, dinoprostone, or Foley catheter ripening in women with preeclampsia, with follow-up extending to five years postpartum.
Methods: We analyzed 612 women with preeclampsia at or beyond 34 weeks' gestation induced across three tertiary centers between 2016 and 2020, comparing time to vaginal delivery, cesarean rate, severe maternal morbidity, and neonatal outcomes by induction method, with maternal cardiovascular and renal follow-up through 2025.
Results: Mechanical (Foley catheter) and combination ripening were associated with shorter induction-to-delivery intervals than prostaglandin alone without increasing cesarean rates, and induction at diagnosis versus expectant management reduced composite severe maternal morbidity consistent with prior trial evidence. Five-year follow-up showed elevated rates of chronic hypertension and reduced renal function among women with early-onset preeclampsia regardless of induction method.
Conclusions: Induction protocol choice in preeclampsia meaningfully affects delivery timing and short-term morbidity without altering long-term cardiovascular risk, which instead tracks disease severity and gestational age at onset, supporting protocolized induction alongside sustained postpartum cardiovascular surveillance.
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