Induction of labor is indicated for many obstetrical, maternal, and fetal indications.
Induction can be offered for pregnancy at 39 weeks’ gestation. No prediction method
is considered sensitive or specific enough to determine the incidence of cesarean
delivery after induction. A combination of 60- to 80-mL single-balloon Foley catheter
for 12 hours and either 25-μg oral misoprostol initially, followed by 25 μg every
2–4 hours, or 50 μg every 4–6 hours (if no more than 3 contractions per 10 minutes
or previous uterine surgery), or oxytocin infusion should be recommended for induction
of labor. Adding membrane stripping at the beginning of induction should be considered.
Once 5–6 cm of cervical dilation is achieved during the induction of labor, consideration
can be given to discontinue oxytocin infusion if in use at that time and adequate
contractions are present. Induction with oxytocin immediately (as soon as feasible)
or up to 12 hours of term prelabor rupture of membranes if labor is not evident is
recommended. Outpatient Foley ripening can be considered for low-risk women. Cesarean
delivery should not be performed before 15 hours of oxytocin infusion and amniotomy
if feasible and ideally after 18–24 hours of oxytocin infusion.
Key words
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Article info
Publication history
Accepted:
April 27,
2020
Received in revised form:
April 25,
2020
Received:
March 3,
2020
Footnotes
The authors report no conflict of interest.
Identification
Copyright
© 2020 Elsevier Inc. All rights reserved.
