Induction of labour

Abstract

Induction of labour has been described for many centuries. However, as fetal outcomes improve in general and the safety of the induction process increases, it is increasingly used to reduce the risk of adverse fetal outcomes in late pregnancy. Common obstetric indications include postdates pregnancy, hypertension, spontaneous membrane rupture, fetal growth restriction, and reduced fetal movements. Increased background risk is also an indication with potential benefits for women with increased age, body mass index, and a ‘bad obstetric history’. Induction without medical indication also appears to be safe and does not increase maternal or fetal adverse outcomes. A wide variety of induction methods are available and the choice between them depends on availability and setting. Vaginal dinoprostone, oral misoprostol, and the balloon catheter are all effective and safe methods.