Labor induction

Determining the optimal timing for induction of labor is critical in minimizing the risks to maternal and fetal health. While data are available to guide us in some clinical situations, such as hypertension and diabetes, many gaps in knowledge still exist in others, including cholestasis of pregnancy, fetal anomalies, and placental abruption. This review of the currently available literature assesses the risks and benefits of preterm and early term induction in a wide variety of maternal and fetal conditions...

OBJECTIVE: History of fast labor is currently subjectively defined and inductions for non-medical indications are becoming restricted. We hypothesized that women induced for a history of fast labor do not have faster previous labors and do not deliver more quickly. METHODS: A retrospective case-control cohort design studied multiparas undergoing elective induction at one high risk center. Outcomes of dyads electively induced for a history of previous fast labor indication (PFast) were compared to controls with a psychosocial indication...

Rates of labor induction in the United States have more than doubled in the past 2 decades. Trends of indications and risk factors related to induction of labor are also increasing. Professional organizations such as the American College of Obstetricians and Gynecologists and The Joint Commission have taken steps to discourage elective induction of labor prior to 39 weeks' gestation and have created new definitions of early-term, full-term, late-term, and postterm gestation to guide clinicians in the timing of birth for specified indications...

OBJECTIVES: Induction of labour is the process of artificially initiating labour in order to end a pregnancy. We sought to explore changes in practice as documented in 'Ten Teachers', an undergraduate textbook that was first published in 1917 and is now in its 19th edition. STUDY DESIGN: The description of labour induction methods from each edition were described and tabulated. RESULTS: Historically, the dangers of induction meant that it was only conducted in the event of life-threatening maternal disease...

OBJECTIVE: The purpose of this study was to compare maternal and neonatal outcomes in nulliparous women with nonmedically indicated inductions at term vs those expectantly treated. STUDY DESIGN: Data were obtained from maternal and neonatal charts for all deliveries on randomly selected days across 25 US hospitals over a 3-year period. A low-risk subset of nulliparous women with vertex nonanomalous singleton gestations who delivered 38 0/7 to 41 6/7 weeks were selected...

BACKGROUND: The optimal dose of misoprostol for the induction of labour remains uncertain. OBJECTIVES: To compare the efficacy and safety of 25 versus 50 micrograms of intravaginal misoprostol tablets for the induction of labour and cervical ripening. SEARCH STRATEGY: We performed electronic and manual searches to identify relevant randomised trials. SELECTION CRITERIA: The efficacy outcomes assessed were rates of vaginal delivery within 24 hours, delivery within one dose, and oxytocin augmentation, and interval to delivery...

Elective induction of labor is a controversial topic. An observed relationship between elective induction and primary cesarean delivery has been of particular concern, and has guided much of the research to date on both indicated and elective induction of labor. However, it is unclear whether elective induction of labor actually increases the risk of cesarean delivery. This chapter focuses on key method issues to consider in studies of elective induction of labor. We first identify methodological concerns with the existing literature and discuss each in turn...

INTRODUCTION: Elective induction of labor is common despite the paucity of prospective data on maternal and neonatal outcomes. The objective of this study was to investigate the effect of induction of labor, at 39 weeks of gestation, on the frequency of cesarean delivery in nulliparous women with an unfavorable cervix compared with expectant management. METHODS: Nulliparous women aged 18-40 years with an uncomplicated pregnancy and a Bishop score of 5 or less receiving care at single medical center were assigned to induction of labor at 39 weeks of gestation or to expectant management in a parallel group randomized clinical trial...

INTRODUCTION: In an effort to decrease cesarean delivery rates, an institutional review of inductions performed at or beyond 39 weeks of gestation was designed to identify potential risk factors. METHODS: A retrospective chart review of patients undergoing an induction of labor between 39 and 42 weeks of gestation was performed at a single institution over a 7-month time period. Information abstracted included gestational age, parity, and Bishop score. Records were reviewed to determine induction agents, delivery route, and neonatal outcomes...

Over the years, multiple forms and doses of pharmacologic agents have been used for cervical ripening and labor induction. This chapter will review potential criteria and article situations for choosing a particular pharmacologic agent. The discussion in this chapter will be limited to comparisons between pharmacologic agents; direct comparisons between mechanical agents and pharmacologic agents will largely be reviewed in the accompanying article: Methods of cervical ripening and labor induction: mechanical...