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F1000Research 2019The rate of labor induction is steadily increasing and, in industrialized countries, approximately one out of four pregnant women has their labor induced. Induction of... (Review)
Review
The rate of labor induction is steadily increasing and, in industrialized countries, approximately one out of four pregnant women has their labor induced. Induction of labor should be considered when the benefits of prompt vaginal delivery outweigh the maternal and/or fetal risks of waiting for the spontaneous onset of labor. However, this procedure is not free of risks, which include an increase in operative vaginal or caesarean delivery and excessive uterine activity with risk of fetal heart rate abnormalities. A search for "Induction of Labor" retrieves more than 18,000 citations from 1844 to the present day. The aim of this review is to summarize the controversies concerning the indications, the methods, and the tools for evaluating the success of the procedure, with an emphasis on the scientific evidence behind each.
Topics: Cesarean Section; Female; Humans; Labor, Induced; Oxytocics; Pregnancy
PubMed: 31723412
DOI: 10.12688/f1000research.17587.1 -
American Family Physician Feb 2022Induction of labor is a common obstetric procedure, and approximately one-fourth of pregnant patients undergo the procedure. Although exercise and nipple stimulation can...
Induction of labor is a common obstetric procedure, and approximately one-fourth of pregnant patients undergo the procedure. Although exercise and nipple stimulation can increase the likelihood of spontaneous labor, sexual intercourse may not be effective. Acupuncture has been used for labor induction; however, it has not been shown to increase vaginal delivery rates. There is strong evidence that membrane sweeping can increase the likelihood of spontaneous labor within 48 hours. Cervical preparation or ripening is often needed before induction. Some evidence shows that the use of nonpharmacologic approaches such as osmotic dilators and cervical ripening balloons reduce time to delivery. The effect of amniotomy on labor is uncertain. Pharmacologic intervention with oxytocin or prostaglandins is effective for cervical ripening and induction of labor. Combining a balloon catheter with misoprostol is a common practice and has been shown to decrease time to delivery in a small study.
Topics: Cervical Ripening; Female; Humans; Labor, Induced; Misoprostol; Oxytocics; Oxytocin; Pregnancy
PubMed: 35166491
DOI: No ID Found -
BMC Pregnancy and Childbirth Oct 2011Rates of labour induction are increasing. We conducted this systematic review to assess the evidence supporting use of each method of labour induction. (Review)
Review
BACKGROUND
Rates of labour induction are increasing. We conducted this systematic review to assess the evidence supporting use of each method of labour induction.
METHODS
We listed methods of labour induction then reviewed the evidence supporting each. We searched MEDLINE and the Cochrane Library between 1980 and November 2010 using multiple terms and combinations, including labor, induced/or induction of labor, prostaglandin or prostaglandins, misoprostol, Cytotec, 16,16,-dimethylprostaglandin E2 or E2, dinoprostone; Prepidil, Cervidil, Dinoprost, Carboprost or hemabate; prostin, oxytocin, misoprostol, membrane sweeping or membrane stripping, amniotomy, balloon catheter or Foley catheter, hygroscopic dilators, laminaria, dilapan, saline injection, nipple stimulation, intercourse, acupuncture, castor oil, herbs. We performed a best evidence review of the literature supporting each method. We identified 2048 abstracts and reviewed 283 full text articles. We preferentially included high quality systematic reviews or large randomised trials. Where no such studies existed, we included the best evidence available from smaller randomised or quasi-randomised trials.
RESULTS
We included 46 full text articles. We assigned a quality rating to each included article and a strength of evidence rating to each body of literature. Prostaglandin E2 (PGE2) and vaginal misoprostol were more effective than oxytocin in bringing about vaginal delivery within 24 hours but were associated with more uterine hyperstimulation. Mechanical methods reduced uterine hyperstimulation compared with PGE2 and misoprostol, but increased maternal and neonatal infectious morbidity compared with other methods. Membrane sweeping reduced post-term gestations. Most included studies were too small to evaluate risk for rare adverse outcomes.
CONCLUSIONS
Research is needed to determine benefits and harms of many induction methods.
Topics: Administration, Intravaginal; Dinoprostone; Female; Humans; Infusions, Intravenous; Labor, Induced; Misoprostol; Oxytocics; Oxytocin; Pregnancy; Randomized Controlled Trials as Topic; Time Factors
PubMed: 22032440
DOI: 10.1186/1471-2393-11-84 -
Acta Obstetricia Et Gynecologica... Feb 2021
Topics: Cesarean Section; Clinical Decision-Making; Female; Gestational Age; Humans; Labor, Induced; Pregnancy
PubMed: 33470440
DOI: 10.1111/aogs.14068 -
Obstetrics and Gynecology Feb 2021
Topics: Delivery, Obstetric; Female; Humans; Labor, Induced; Labor, Obstetric; Pregnancy; Probability; Watchful Waiting
PubMed: 33481510
DOI: 10.1097/AOG.0000000000004261 -
Acta Obstetricia Et Gynecologica... Aug 2019
Topics: Adult; Cesarean Section; Female; Gestational Age; Humans; Labor, Induced; Labor, Obstetric; Pregnancy; Pregnancy Outcome; Unnecessary Procedures
PubMed: 31328261
DOI: 10.1111/aogs.13683 -
Medecine Sciences : M/S Oct 2013
Topics: Comorbidity; Female; Fetal Organ Maturity; France; Gestational Age; Humans; Infant, Newborn; Intensive Care, Neonatal; Labor, Induced; Pregnancy; Premature Birth; Terminology as Topic; United States
PubMed: 24148112
DOI: 10.1051/medsci/20132910001 -
BMJ (Clinical Research Ed.) Nov 2019To evaluate if induction of labour at 41 weeks improves perinatal and maternal outcomes in women with a low risk pregnancy compared with expectant management and... (Randomized Controlled Trial)
Randomized Controlled Trial
Induction of labour at 41 weeks versus expectant management and induction of labour at 42 weeks (SWEdish Post-term Induction Study, SWEPIS): multicentre, open label, randomised, superiority trial.
OBJECTIVE
To evaluate if induction of labour at 41 weeks improves perinatal and maternal outcomes in women with a low risk pregnancy compared with expectant management and induction of labour at 42 weeks.
DESIGN
Multicentre, open label, randomised controlled superiority trial.
SETTING
14 hospitals in Sweden, 2016-18.
PARTICIPANTS
2760 women with a low risk uncomplicated singleton pregnancy randomised (1:1) by the Swedish Pregnancy Register. 1381 women were assigned to the induction group and 1379 were assigned to the expectant management group.
INTERVENTIONS
Induction of labour at 41 weeks and expectant management and induction of labour at 42 weeks.
MAIN OUTCOME MEASURES
The primary outcome was a composite perinatal outcome including one or more of stillbirth, neonatal mortality, Apgar score less than 7 at five minutes, pH less than 7.00 or metabolic acidosis (pH <7.05 and base deficit >12 mmol/L) in the umbilical artery, hypoxic ischaemic encephalopathy, intracranial haemorrhage, convulsions, meconium aspiration syndrome, mechanical ventilation within 72 hours, or obstetric brachial plexus injury. Primary analysis was by intention to treat.
RESULTS
The study was stopped early owing to a significantly higher rate of perinatal mortality in the expectant management group. The composite primary perinatal outcome did not differ between the groups: 2.4% (33/1381) in the induction group and 2.2% (31/1379) in the expectant management group (relative risk 1.06, 95% confidence interval 0.65 to 1.73; P=0.90). No perinatal deaths occurred in the induction group but six (five stillbirths and one early neonatal death) occurred in the expectant management group (P=0.03). The proportion of caesarean delivery, instrumental vaginal delivery, or any major maternal morbidity did not differ between the groups.
CONCLUSIONS
This study comparing induction of labour at 41 weeks with expectant management and induction at 42 weeks does not show any significant difference in the primary composite adverse perinatal outcome. However, a reduction of the secondary outcome perinatal mortality is observed without increasing adverse maternal outcomes. Although these results should be interpreted cautiously, induction of labour ought to be offered to women no later than at 41 weeks and could be one (of few) interventions that reduces the rate of stillbirths.
TRIAL REGISTRATION
Current Controlled Trials ISRCTN26113652.
Topics: Adult; Cesarean Section; Female; Gestational Age; Humans; Infant; Infant Mortality; Infant, Newborn; Infant, Newborn, Diseases; Intention to Treat Analysis; Labor, Induced; Pregnancy; Pregnancy Outcome; Stillbirth; Sweden; Term Birth; Watchful Waiting
PubMed: 31748223
DOI: 10.1136/bmj.l6131 -
Pregnancy Hypertension Oct 2017To study patterns of induced labor at term in hypertensive women.
OBJECTIVE
To study patterns of induced labor at term in hypertensive women.
STUDY DESIGN
We performed a retrospective cohort study using the Consortium on Safe Labor database; a multicenter study of labor and delivery practices from electronic medical records in 19 hospitals. 55,572 women were studied: 28,254 nulliparas and 27,318 multiparas, undergoing induction of labor at term without a prior cesarean with a singleton vertex live born fetus. Four hypertensive groups were defined: chronic hypertension (n=1164), gestational hypertension (n=1861), preeclampsia (n=1513) and superimposed preeclampsia (n=655), compared to controls (no hypertension, n=50,379). Labor characteristics and patterns were compared among the groups, stratified by parity.
MAIN OUTCOME MEASURES
Interval-censored regression analysis estimated median and 95th% duration of labor, stratified by centimeter-by-centimeter dilation. Repeated-measures analysis established mean labor curves.
RESULTS
Time to progress from 4 to 10 cm was 7.5, 6.4, 4.9 and 4.6h in nulliparous women with superimposed preeclampsia, chronic hypertension, preeclampsia and gestational hypertension respectively, which differed from controls (4.9h; p<0.05 for chronic hypertension and superimposed preeclampsia). Multiparous women required 3.8, 3.9, 3.2 and 3.3h, respectively, compared to controls (3.2h, p<0.05 except preeclampsia p=0.1) to progress from 4 to 10cm. Second stage of labor without epidural was longer for all nulliparous groups compared to controls except for women with chronic hypertension, but second stage did not differ in multiparas.
CONCLUSION
Regardless of parity, women with chronic disease, chronic hypertension and superimposed preeclampsia, labor longer whereas those with relatively acute disease, gestational hypertension and preeclampsia, progress more rapidly.
Topics: Adult; Cohort Studies; Databases, Factual; Female; Humans; Labor Stage, First; Labor Stage, Second; Labor Stage, Third; Labor, Induced; Pre-Eclampsia; Pregnancy; Retrospective Studies; Term Birth; Time Factors
PubMed: 29153691
DOI: 10.1016/j.preghy.2017.06.003 -
Taiwanese Journal of Obstetrics &... Nov 2022
Topics: Pregnancy; Female; Humans; Labor, Induced; Cesarean Section
PubMed: 36427993
DOI: 10.1016/j.tjog.2022.08.001