Elective Induction of Labor at Term: Has Its Time Arrived?

In low-risk nulliparous women, compared with expectant management, labor induction at 39 weeks was associated with lower likelihood of cesarean delivery.

Obstetric practice has long held that elective induction of labor is inadvisable because it raises risk for cesarean delivery. This dictum was based on observational data assessing outcomes of induced versus spontaneous labor, a comparison that is not clinically pertinent: In real-world practice, the decision is between labor induction and expectant management. In a multicenter U.S.-based randomized trial, investigators have examined these strategies head to head, with a focus on risk for cesarean delivery and a composite outcome of perinatal harm. Some 22,000 nulliparous women at low risk for adverse obstetric outcomes were invited to participate; of these, 71% declined, leaving a cohort of 6100 women randomly assigned to labor induction (…

Reviewing Author

Allison Bryant, MD, MPH

Disclosures

RoyaltiesUpToDate

Leadership Positions in Professional SocietiesSociety for Maternal-Fetal Medicine (Board of Directors)

Allison Bryant, MD, MPH

Disclosures

RoyaltiesUpToDate

Leadership Positions in Professional SocietiesSociety for Maternal-Fetal Medicine (Board of Directors)

Elective Induction of Labor at Term: Has Its Time Arrived?

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Reviewing Author