7 - Induction of labour

Summary

Spontaneous onset of labour at term is the most desirable finale of pregnancy, heralding, as it usually does, the maturation of both fetal and maternal systems necessary for childbirth. Induction of labour is second best and this intervention is justified only for clear maternal, fetal or combined reasons. In induction of labour, uterine contractions are initiated by mechanical and/or pharmacological methods with the aim of achieving vaginal delivery. The options for induction of labour available in each centre should be discussed with the woman, including the possible success and failure rates and complications. The conditions for which induction is carried out will vary and depend on the medical or obstetric condition of the mother, the fetal condition, the knowledge and experience of the clinician, the willingness of the woman to undergo the procedure and the facilities available. Hence, the rates of induction of labour in the UK vary from 10% to 20%.

Indications and contraindications for induction of labour

There are several indications for induction of labour, the most common being:

1. • prolonged pregnancy (> 41 weeks)

2. • preterm prelabour rupture of membranes

3. • fetal growth restriction

4. • maternal conditions such as pre-eclampsia, diabetes, cholestasis or systemic lupus erythematosus

5. • abnormal antenatal fetal surveillance tests.