Elective and routine induction of labor. A retrospective analysis of 274 cases

A retrospective analysis of elective induction of labor at term and routine induction after 42 completed weeks' gestation was conducted to assess neonatal and maternal outcome in a low-risk obstetric population at a tertiary care facility. In 1989, 639 labor inductions were performed at the Christ Hospital and Medical Center. Two hundred one inductions were performed between 37 and 41 6/7 weeks' (elective induction), while 73 were performed at 42 weeks' gestation and beyond (routine induction). Cervical status was ascertained on admission. Patients undergoing routine induction had a longer second stage of labor as compared to patients undergoing elective induction. Otherwise the duration of labor and membrane rupture did not significantly differ between the two groups. Nulliparous patients with an unfavorable cervix who were induced electively had a trend toward a higher cesarean section rate than nulliparas with an unfavorable cervix induced routinely. There was no difference between the elective and routine induction populations with respect to the incidence of fetal distress, neonatal outcome or maternal outcome. Respiratory distress syndrome was noted in three cases, all secondary to meconium aspiration and all from the elective induction group. The incidence of birth weight > or = 4,000 g was equal in the elective and routine induction groups, and no birth weights < or = 2,500 g were recorded. No cases of iatrogenic prematurity were noted, either. When compared to routine induction after 42 weeks' gestation, there is no advantage to elective induction, especially in nulliparous patients with unfavorable cervixes.