Induction of labor and cesarean section

Does induction of labor (IOL) increase the rate Cesarean section? This is not an uncommon question, and it impossible to provide answer. because question incomplete. The complete would be: associated with a higher section compared …….? answer depends on what filled in gap. If spontaneous labor, IOL consistently observed be than those women labor.1, 2 gap by ‘expectant management’, there increasing evidence show that does rate. true only for all indications IOL3 but also elective (for non-medical reasons) IOL.4, 5 In this issue AOGS, Zenzmier et al6 explore using different definitions expectant management. authors argue late term (42+0 or more) pregnancies very high section, earlier (40+0 weeks example) may appear have lower who are induced at 40+0 (which include beyond 42+0 C rate). They propose two management’: (a) births next week (b) week. report no group management, when management defined as beyond. When was week, significantly odds (OR 0.76; 95% CI: 0.70-0.82; P < .001). defining control could useful clinical decision-making. Are we convinced argument prior 41+0 weeks, one can see reduced delaying more? Let us look decision-making process. considering decision induce alternative? Clearly, alternative labor. cannot ‘spontaneous labor’. made happen. Thus, self-selected. hardly surprising. Comparing undergoing comparing like like. By same token, inducing particular birth (following labor). It likely vast majority following result least till weeks. surprise then, birthing situation change has been shown risk sub-group.7 believe achieved expects success steadily (or progressively decrease) gestation from 37+0 other words, think further away before due date, less successful be. stand up scrutiny? Table 1 shows several publications. includes data current manuscript Zenzmeier al.6 nulliparous twice women, which key finding indication any influence even analysis restricted women. do support hypothesis I suspect small sub-group pregnant - probably unripe cervix resistant whenever attempted. am avoided more. waiting then if still undelivered? does. One 37, 38 39 they deemed more suitable (inducible) therefore Therefore, difficult based solely observational will need RCT. important remember downsides labors longer4 admission neonatal unit weeks.5 Women particularly induction.10 However, many one. should feature risk-benefit None declared.