Mild Induced Labor and C-Sections

2022 19 Project FLRF

Mild Induced Labor Prior to Planned Caesarean Sections to Improve Neonatal and Maternal Outcomes (LACARUS Trial).

Epidemiological studies indicate that mothers who deliver their babies by caesarean section (C-section) are more likely to experience breastfeeding difficulties than mothers who deliver their babies spontaneously. As birth rates by C-section rise – and in some regions outpace those of spontaneous birth rates – further investigation is needed to better understand the initial findings and develop potential solutions.

Led by Professor Tilo Burkhard at the University Hospital of Zurich, and in close cooperation with the University Children’s Hospital in Basel, this collaborative, clinical study is examining how the mild induction of labor using oxytocin could support mothers who deliver by C-section to initiate and continue breastfeeding. 

The study is also being conducted at: University Hospital BaselCantonal Hospital Baden and Cantonal Hospital St. Gallen

Results could form the scientific basis for improving the medical protocol for C-sections globally, which could in turn reduce neonatal mortality, reduce the rate of NICU admissions and increase breastfeeding rates.

The study launched in 2018 with support from FLRF - read the press release

Wellmann S, Manegold-Brauer G, Fischer T, Schäffer L, Gaertner VD, Malfertheiner SF, et al. Improving neonatal and maternal outcome by inducing mild labor before elective cesarean section: The Lacarus randomized controlled trial. Neonatology. 2021;118(1):116–21. DOI: 10.1159/000512752

Fill Malfertheiner S, Bataiosu-Zimmer E, Michel H, Fouzas S, Bernasconi L, Bührer C, et al. Vasopressin but not oxytocin responds to birth stress in infants. Front Neurosci. 2021;15:718056. DOI: 10.3389/fnins.2021.718056

Wilbaux M, Kasser S, Gromann J, Mancino I, Coscia T, Lapaire O et al. Personalized weight change prediction in the first week of life. Clin Nutr. 2019 Apr;38(2):689-696. DOI: 10.1016/j.clnu.2018.04.001.

Wellmann S, Koslowski A, Spanaus K, Zimmermann R, Burkhardt T. Fetal Release of Copeptin in Response to Maternal Oxytocin Administration: A Randomized Controlled Trial. Obstet Gynecol. 2016;128(4):699-703. DOI: 10.1097/AOG.0000000000001594.

Prior E, Santhakumaran S, Gale C, Philipps LH, Modi N, Hyde MJ. Breastfeeding after cesarean delivery: a systematic review and meta-analysis of world literature. Am J Clin Nutr. 2012;95(5):1113-35. DOI: 10.3945/ajcn.111.030254. Epub 2012 Mar 28.

Evans KC, Evans RG, Royal R, Esterman AJ, James SL. Effect of caesarean section on breast milk transfer to the normal term newborn over the first week of life. Arch Dis Child Fetal Neonatal Ed. 2003 Sep;88(5):F380-2.

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