The Increase In Induction: Unnecessary Or Saving More Babies?(induced labor)

2002 JAN 10 - (NewsRx.com & NewsRx.net) -- Fears that a rise in the incidence of induced labor is attributable to patient or physician preferences alone appear to be unjustified, according to Charles J. Lockwood, MD, professor and chair of the ob-gyn department at New York University School of Medicine.

In the past 10 years the percentage of deliveries resulting from labor induction has more than doubled, from approximately 8% in 1989 to 19.6% last year, Lockwood reported at a recent American College of Obstetricians and Gynecologists (ACOG) press conference.

"Concern has arisen that these inductions are being done for either patient or physician convenience," Lockwood noted. "This seems unlikely for a number of reasons."

In the last decade, a number of excellent clinical trials have suggested that various conditions that were previously treated by observation are better managed by the induction of labor, he said. These conditions include premature rupture of the membranes at term (which affects 3% of all deliveries); preeclampsia (5% of all deliveries); severe fetal growth restriction (3%); postdate pregnancies (4%); and a variety of other maternal medical conditions complicating nearly 5% of deliveries. "When one adds these bona fide indications for the induction of labor together, they actually exceed the number of inductions performed in the U.S.," he said.

"ACOG also continues to aggressively educate its members that inductions of labor should only be performed when the risk of continuing the pregnancy exceeds the risk of induction of labor," added Lockwood.

Both Lockwood and Michael F. Greene, MD, director of maternal-fetal medicine at Massachusetts General Hospital in Boston, cited recent warnings that labor inductions using prostaglandins carry risks for patients with prior uterine scars and cesarean delivery who are attempting a vaginal delivery. "Recent reports in the New England Journal of Medicine suggest that all prostaglandins used to induce labor in women with prior cesarean deliveries could increase the risk of infant mortality," reported Greene.