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Elective induction of labor.

Lisa E Moore¹, William F Rayburn

¹Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, School of Medicine, University of New Mexico, Albuquerque, New Mexico 87131-0001, USA. LMoore@salud.unm.edu

Clinical Obstetrics and Gynecology

|August 4, 2006

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Induction of labor rates have doubled, with elective inductions driving the increase. More research is needed to understand the patient and provider satisfaction and impact on cesarean delivery rates.

Area of Science:

Obstetrics and Gynecology
Maternal-Fetal Medicine

Background:

Nationwide induction of labor rates have more than doubled in the past 15 years.
The rise in medically indicated inductions is slower than the overall increase, suggesting a significant rise in elective or marginal inductions.
Elective inductions constitute at least 50% of all inductions and 10% of all deliveries.

Purpose of the Study:

To examine the patient, obstetrician, and intrapartum crew satisfaction with elective labor induction.
To assess the impact of elective induction on cesarean delivery rates, particularly in nulliparous women with unfavorable cervices.
To highlight the need for more prospective studies to evaluate the true impact of elective induction on population-wide cesarean delivery rates.

Main Methods:

This study is a review and analysis of existing literature and trends in labor induction.

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It identifies a lack of prospective studies specifically evaluating elective induction outcomes.

Proposes strategies for increased obstetrician awareness through practice guidelines and clinical research.

Main Results:

Cesarean delivery rates are notably high for nulliparous women undergoing induction with an unfavorable cervix.
Prospective studies investigating elective induction are limited, making it difficult to ascertain its precise impact.
Elective inductions appear to account for a substantial proportion of all inductions and overall deliveries.

Conclusions:

The rising rates of elective labor induction warrant further investigation into patient and provider satisfaction.
More prospective research is crucial to accurately evaluate the effect of elective induction on cesarean delivery rates.
Developing practice guidelines and conducting clinical trials are recommended to improve obstetrician awareness and management of labor induction.