Elective induction of labor: a prospective clinical study, I: Obstetric and neonatal effects

Elective induction of labor is still a controversial obstetric procedure. The safety of the procedure and the possibility to program labor during daytime is an often heard argument in favor of it. Also the possibility to prevent term intrauterine fetal death of unknown cause and the possibility to apply fetal monitoring from the beginning of labor are put forward as arguments in favor of elective induction of labor. Feelings of unnaturalness and the dangers of prematurely induced delivery are the most often heard arguments against it. We performed a prospective study to determine the differences between elective induction of labor and spontaneous labor. During 17 consecutive months a group of 184 elective inductions was studied in the Department of Obstetrics, University Hospital - Dijkzigt, Rotterdam. Only healthy women with an uncomplicated pregnancy were included in the study group and all women were allowed a free choice of elective induction or spontaneous labor. The reference group was composed by a system of "matched controls". For induction of labor a standard technique including artificial rupture of the membranes and constant intrauterine fetal monitoring was used. Oxytocin was administered intravenously in an incremental dose. After delivery the acid-base status of the newborns was determined, and part of the newborns were subjected to a neurological screening according to Prechtl. The developments of the infants was followed during one year using a "psychomotor development scheme 0-15 months".(ABSTRACT TRUNCATED AT 250 WORDS)