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Minimizing the risks from elective induction of labor.

William F Rayburn¹

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

The Journal of Reproductive Medicine

|September 21, 2007

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Elective labor induction is increasingly common, but carries risks like higher cesarean rates for women with unfavorable cervices. Further research is needed to assess its population-level impact and patient satisfaction.

Area of Science:

Obstetrics and Gynecology
Maternal-Fetal Medicine

Background:

Elective labor induction is becoming more prevalent, accounting for about 10% of deliveries.
Despite increasing acceptance, the evidence base for elective induction is not robust.

Purpose of the Study:

To systematically review the risks associated with elective induction of labor.
To evaluate the current literature on elective induction of labor and its outcomes.

Main Methods:

A systematic literature review was conducted using MEDLINE.
Searched for articles in English from core clinical journals published between 1996 and 2005.
Included earlier articles if they provided relevant historical context.

Main Results:

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A significant risk of elective induction is a higher cesarean delivery rate, particularly for nulliparous women with an unfavorable cervix.

Induction may lead to a prolonged intrapartum course, potentially overutilizing healthcare resources.

The impact of elective induction on population-wide cesarean delivery rates remains difficult to ascertain without larger prospective trials.

Conclusions:

Larger prospective clinical trials are necessary to fully evaluate the population-level impact of elective labor induction.
Focus should also be placed on patient and provider satisfaction with the elective induction experience.
Current data suggests caution is warranted, especially for nulliparous women with unfavorable cervices.