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Chapter 20 - Induction of Labour

Published online by Cambridge University Press:  16 October 2025

By
Sabaratnam Arulkumaran
Edited by
Sir Sabaratnam Arulkumaran
Sir Sabaratnam Arulkumaran
Affiliation:
St George's Hospital Medical School, University of London
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Summary

Globally the rates of induction of labour (IOL) are on the rise. The availability of prostaglandins, which act as both cervical ripening as well as inducing agent, has improved the success rates of IOL in the presence of an unfavourable cervix. Mechanical methods such as intracervical balloon catheters appear to be equally effective as compared to pharmacological agents and have fewer adverse effects. The process of IOL is associated with significant risks such as uterine hyperstimulation, fetal compromise, increased risk of operative deliveries and rarely rupture of the uterus. Hence, there should be a clear indication for IOL based on best available evidence, with benefits to either mother or fetus, which outweigh the perceived risks. The World Health Organization, the National Institute for Health and Clinical Care Excellence and various professional organisations have produced guidelines to assist clinicians in decision-making regarding IOL in various obstetric situations. The process of IOL should be tailored to meet the expectations and preferences of women in their unique circumstances.

Keywords

induction of labouroxytocinprostaglandinprolonged pregnancyfailed inductionintrauterine deathfetal distressuterine hyperstimulation

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Type
Chapter
Information
Best Practice in Labour and Delivery , pp. 246 - 263
Publisher: Cambridge University Press
Print publication year: 2025

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