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Revised Labor Induction Guidelines Published

Bulletin details how and when to induce labor

THURSDAY, July 23 (HealthDay News) -- Revised guidelines have been published detailing how and under what circumstances to induce labor, according to a practice bulletin issued by the American College of Obstetricians and Gynecologists and published in the August issue of Obstetrics & Gynecology.

Noting that more than 22 percent of pregnant women in the United States now have their labor induced, the review states that this is appropriate in certain medical and non-medical circumstances. If term-gestation criteria has been confirmed, appropriate circumstances include fetal demise or compromise, gestational hypertension, post-term pregnancy, maternal medical conditions, or logistic reasons. Labor should not be induced under circumstances such as previous Caesarean delivery, transverse fetal lie, or previous myomectomy entering the endometrial cavity.

The bulletin further notes that cervical ripening can be induced mechanically or by misoprostol, which also induces labor, followed by oxytocin administration; stripping the amniotic membranes; rupture of the amniotic membrane; or nipple stimulation. However, misoprostol should not be used to induce labor in women who have had even one prior Caesarean delivery, due to the possibility of uterine rupture.

"These practice guidelines classify the indications for and contraindications to induction of labor, describe the various agents used for cervical ripening, cite methods used to induce labor, and outline the requirements for the safe clinical use of the various methods of inducing labor," the authors state.

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