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External Cephalic Version: Is it an Effective and Safe Procedure?
Published on: June 6, 2020
Elective induction versus spontaneous labour in Latin America
Gláucia Virgínia Guerra1, José Guilherme Cecatti, João Paulo Souza
1Department of Obstetrics and Gynaecology, School of Medical Sciences, University of Campinas, SP, Brazil.
Bulletin of the World Health Organization
|September 8, 2011
Summary
Elective labor induction in low-risk pregnancies increases maternal risks, including intensive care unit admission and postpartum hysterectomy. While vaginal delivery is common, caution is advised due to these adverse outcomes.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Public Health
Background:
- Elective induction of labor is increasingly common globally.
- Limited data exists on its safety and determinants in Latin America.
- Low-risk pregnancies are often considered suitable for induction.
Purpose of the Study:
- To determine the frequency and factors influencing elective labor induction in Latin America.
- To assess the success rate of vaginal delivery following induction.
- To compare maternal and perinatal outcomes between elective induction and spontaneous labor in low-risk pregnancies.
Main Methods:
- A retrospective analysis of 37,444 deliveries in low-risk pregnancies.
- Comparison of outcomes between 1847 electively induced labors and spontaneous labors.
- Statistical analysis using logistic regression to calculate odds ratios and relative risks.
Main Results:
- Elective induction occurred in 4.9% of low-risk deliveries, with oxytocin being the most common method.
- 88.2% of induced deliveries resulted in vaginal birth.
- Maternal adverse events included higher postpartum need for uterotonics, increased ICU admission (nearly threefold risk), higher risk of postpartum hysterectomy (fivefold risk), and increased need for anesthesia/analgesia.
- Perinatal outcomes showed a 22% higher risk of delayed breastfeeding.
Conclusions:
- Elective labor induction in low-risk pregnancies is associated with increased maternal and perinatal adverse outcomes.
- The benefits of elective induction do not appear to outweigh the identified risks.
- Caution is recommended when considering elective labor induction.
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