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Staff Education Can Help Reduce Elective Labor Inductions

Proper enforcement of guidelines cuts out inappropriate inductions

TUESDAY, March 31 (HealthDay News) -- Staff education and more rigorous enforcement of guidelines for labor induction can reduce the number of unwarranted inductions and lower the cesarean birth rate for first-time births, researchers report in the April issue of Obstetrics & Gynecology.

John M. Fisch, M.D., of the Magee-Womens Hospital of the University of Pittsburgh Medical Center, and colleagues conducted a study before and after the strict enforcement of elective induction guidelines in their hospital in 2005. The study sample comprised 533 women who gave birth in 2004, 454 who delivered in 2005 and 1,806 who delivered from November 2006 to December 2007. The guidelines stipulated 39 weeks' gestation, and a Bishop score of eight for first-time births and six for subsequent births.

The induction rate dropped from 24.9 percent in 2004 to 16.6 percent in 2007, and there was a 30 percent drop in the rate of elective induction, from 9.1 percent to 6.4 percent, the investigators found. Among first-time electively induced births there was a reduction in cesareans, from 34.5 percent to 13.8 percent, the researchers report.

"The cesarean birth rate, length of stay and cost implications of improving the labor induction process are all reasons that other large institutions struggling with the demands of running an obstetric unit will find this study is of particular interest," the authors write.

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