Document Detail

Indications for induction of labour: a best-evidence review.
MedLine Citation:
PMID:  19191776     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Rates of labour induction are increasing. OBJECTIVES: To review the evidence supporting indications for induction. SEARCH STRATEGY: We listed indications for labour induction and then reviewed the evidence. We searched MEDLINE and the Cochrane Library between 1980 and April 2008 using several terms and combinations, including induction of labour, premature rupture of membranes, post-term pregnancy, preterm prelabour rupture of membranes (PROM), multiple gestation, suspected macrosomia, diabetes, gestational diabetes mellitus, cardiac disease, fetal anomalies, systemic lupus erythematosis, oligohydramnios, alloimmunization, rhesus disease, intrahepatic cholestasis of pregnancy (IHCP), and intrauterine growth restriction (IUGR). We performed a review of the literature supporting each indication. SELECTION CRITERIA: We identified 1387 abstracts and reviewed 418 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 trials and observational studies. MAIN RESULTS: We included 34 full text articles. For each indication, we assigned levels of evidence and grades of recommendation based upon the GRADE system. Recommendations for induction of labour for post-term gestation, PROM at term, and premature rupture of membranes near term with pulmonary maturity are supported by the evidence. Induction for IUGR before term reduces intrauterine fetal death, but increases caesarean deliveries and neonatal deaths. Evidence is insufficient to support induction for women with insulin-requiring diabetes, twin gestation, fetal macrosomia, oligohydramnios, cholestasis of pregnancy, maternal cardiac disease and fetal gastroschisis. AUTHORS' CONCLUSIONS: Research is needed to determine risks and benefits of induction for many commonly advocated clinical indications.
E Mozurkewich; J Chilimigras; E Koepke; K Keeton; V J King
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review     Date:  2009-02-04
Journal Detail:
Title:  BJOG : an international journal of obstetrics and gynaecology     Volume:  116     ISSN:  1471-0528     ISO Abbreviation:  BJOG     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-03-20     Completed Date:  2009-05-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100935741     Medline TA:  BJOG     Country:  England    
Other Details:
Languages:  eng     Pagination:  626-36     Citation Subset:  AIM; IM    
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA.
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MeSH Terms
Labor, Induced*
Obstetric Labor Complications
Patient Selection*
Pregnancy Complications*
Randomized Controlled Trials as Topic
Review Literature as Topic
Risk Assessment

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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