Methods of induction of labour: a systematic review

Abstract

BackgroundRates of labour induction are increasing. We conducted this systematic review to assess the evidence supporting use of each method of labour induction.MethodsWe 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.ResultsWe 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.ConclusionsResearch is needed to determine benefits and harms of many induction methods.

Intervention or interference? The need for expectant care throughout normal labour

“…'sweeping' the membranes, 26,27 and breast stimulation. 28 'Sweeping' the membranes increases the probability of spontaneous labour either within 48 hours or one week, has no adverse outcomes but does cause discomfort.…”

“…28 'Mechanical methods,' such as the introduction of laminaria tents or catheters into the cervix, have much the same result, in terms of stimulating labour, as the use of prostaglandins. 29 Other 'natural' means of inducing labour such as castor oil, 27,30 , acupuncture 27,31 intercourse, or hypnotherapy 27 have not been shown to be successful.…”

The use of medicinal herbs in gynecological and pregnancy-related disorders by Jordanian women: a review of folkloric practice vs. evidence-based pharmacology

“…Cervical priming and induction of labor (Kelly et al 2013). Castor oil-diet initiating labor of pregnant rats (Gao et al 1998(Gao et al , 1999 and in pregnancies at term (Mozurkewich et al 2011;Dante et al 2014) but with possible adverse effects of uterine rupture (Sicuranza & Figueroa 2003) and amniotic fluid embolism causing a cardiorespiratory arrest associated temporally with ingestion of castor oil in a full-term normal pregnancy (Steingrub et al 1988). …”

The association between the regular use of risk-based term IOL and improved birth outcomes in an Italian hospital: A retrospective cohort study

“…However, studies comparing the outcomes of "indicated" IOL to the outcomes of spontaneous labour provide little useful information because, in the presence of an accepted indication, there is generally no choice but to initiate IOL [49,50]. Furthermore, even for women having a "non-indicated" IOL, there usually exist one or more risk factors that underlie the recommendation, or the request, for the IOL [51].…”