Routine early induction in healthy women not supported by evidence

A systematic review has looked at the effects of induction of labour prior to post-term on the mother and baby and concluded that induction prior to post-term is associated with few beneficial outcomes and several adverse outcomes.

The authors, Rydahl et al (2018), explain that the current shift towards earlier induction of labour which is occurring in many areas of the world “may lead to 15–20% more inductions. Given the fact that induction as an intervention can cause harm to both mother and child, it is essential to ensure that the benefits of the change in clinical practice outweigh the harms.” (Rydahl et al 2018).

The review, which focused on outcomes for healthy women, shows that there is cause for concern, however. Induction before post-term was found to be associated with an increased risk of caesarean section, chorioamnionitis, labour dystocia, precipitate labour and uterine rupture. There was a decreased risk of oligohydramnios and meconium stained amniotic fluid.

The authors conclude that, “Induction prior to post-term was associated with few beneficial outcomes and several adverse outcomes. This draws attention to possible iatrogenic effects affecting large numbers of low-risk women in contemporary maternity care. According to The World Health Organization, expected benefits from a medical intervention must outweigh potential harms. Hence, our results do not support the widespread use of routine induction prior to post-term (41+0–6 gestational weeks).” 

Their paper adds to growing concerns about the effects of induction of labour on the health of women and babies.

 

Rydahl, E, Eriksen, L, Juhl, M (2018). Effects of induction of labor prior to post-term in low-risk pregnancies: a systematic review. JBI Database of Systematic Reviews and Implementation Reports doi: 10.11124/JBISRIR-2017-003587

 

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