Induction of labour for improving birth outcomes for women at or beyond term

Abstract

Background-As a pregnancy continues beyond term the risks of babies dying inside the womb or in the immediate newborn period increase. Whether a policy of labour induction at a predetermined gestational age can reduce this increased risk is the subject of this review. Objectives-To evaluate the benefits and harms of a policy of labour induction at term or postterm compared with awaiting spontaneous labour or later induction of labour. Search methods-We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 March 2012). Selection criteria-Randomised controlled trials conducted in women at or beyond term. The eligible trials were those comparing a policy of labour induction with a policy of awaiting spontaneous onset of labour. Cluster-randomised trials and cross-over trials are not included. Quasi-random allocation schemes such as alternation, case record numbers or open randomnumber lists were not eligible. Data collection and analysis-Two review authors independently assessed trials for inclusion. Two review authors independently assessed trial quality and extracted data. Data were

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Stillbirths: recall to action in high-income countries

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“…Implementation research is needed on training, staffing, referral systems, procurement and maintenance of obstetric ultrasound for low-resource settings, as well as critical study of the clinical impact. Correct dating also affects management of post-term pregnancy, where induction of labour may avoid late intrauterine fetal death and labour-related perinatal death [20].…”