Induction of labor

Authors: R. Vlk;  V. Drochýtek
Authors‘ workplace: Gynekologicko-porodnická klinika 2. LF UK a FN Motol, Praha přednosta prof. MUDr. L. Rob, CSc.
Published in: Ceska Gynekol 2016; 81(2): 104-111


Data published in this guideline are based on previous guideline issued by Society of Perinatal Medicine of Czech Gynecological and Obstetrical Society (ČGPS) [55], international guidelines and data from peer-reviewed journals. The fundamental document for this guideline is guideline issued by The Society of Obstetricians and Gynaecologists of Canada (SOGS) Induction of labor, No. 296, 2013 (reviewed 2015) [61]. The literature review is added to the aforementioned document and some of its recommendations are further discussed in this guideline.

Review of literature.

induction, labour, cervical ripening, prostaglandins, oxytocin, uterine rupture


1. ACOG Committee on Practice Bulletins – Obstetrics. ACOG Practice Bulletin No. 107: Induction of labor. Obstet Gynecol, 2009, 114, p. 386–397.

2. Alfirevic, Z., Kelly, AJ., Dowswell, T. Intravenous oxytocin alone for cervical ripening and induction of labour. Cochrane Database Syst Rev, 2009, 4, CD003246.

3. Alfirevic, Z., Weeks, A. Oral misoprostol for induction of labour. Cochrane Database Syst Rev, 2006, 2, CD001338.

4. Amorim, MMR., Muzonzini, G., Hofmeyr, GJ. Buccal or sublingual misoprostol for cervical ripening and induction of labour. Cochrane Database Syst Rev, 2004, CD004221.

5. Bakker, JH., van der Goes, BY., Pel, M., et al. Morning versus mening induction of labour for improving outcomes. Cochrane Database Syst Rev, 2013, 2, CD007707.

6. Biem, SR., Turnell, RW., Olatunbosun, O., et al. A randomised controlled trial of outpatient versus inpatient labour induction with vaginal controlled-release prostaglandin E2: effectiveness and satisfaction. J Obstet Gynaecol Can, 2003, 25, p. 23–31.

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8. Boulvain, M., Stan, C., Irion, O. Membrane sweeping for induction of labour. Cochrane Database Syst Rev, 2005, 1, CD000451.

9. Boulvain, M., Kelly, A., Lohse, C., et al. Mechanical methods for induction of labour. Cochrane Database Syst Rev, 2001, 4, CD001233.

10. Boulvain, M., Stan, C., Irion, O. Elective delivery in diabetic pregnant women. Cochrane Database Syst Rev, 2001, 2, CD001997.

11. Bricker, L., Peden, H., Tomlinson, A., et al. Titrated low-dose vaginal and/or oral misoprostol to induce labour for prelabour membrane rupture: a randomised trial. BJOG, 2008, 115, p. 1503–1511.

12. Buchanan, S., Crowther, C., Levett, K., et al. Planned early birth versus expectant management for women with preterm prelabor rupture of membranes prior to 37 weeks gestation for improving pregnancy outcome. Cochrane Database Syst Rev, 2010, 3, CD004735.

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14. Burnett, JE. Jr. Preinduction scoring: an objective approach to induction of labor. Obstet Gynecol, 1966, 28, p. 479–483.

15. Coonrod, DV., Drachman, D., Hobson, P., Manriquez, M. Nulliparous term singleton vertex cesarean delivery rates: institutional and individual predictors. Am J Obstet Gynecol, 2008, 198, p. 694.e1–694.e11.

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23. Ennen, CS., Bofill, JA., Magann, EF., et al. Risk factors for cesarean delivery in preterm, term, and post-term patients undergoing induction of labour with an unfavourable cervix. Gynecol Obstet Invest, 2009, 67, p. 113–117.

24. French, L. Oral prostaglandin E2 for induction of labour. Cochrane Database Syst Rev, 2001, 2, CD003101.

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28. Hatfield, AS., Sanchez-Ramos, L., Kaunitz, AM. Sonographic cervical assessment to predict the success of labour induction: a systematic review with metaanalysis. Am J Obstet Gynecol, 2007, 197, p. 186–192.

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30. Hofmeyr, GJ., Gülmezoglu, AM., Pileggi, C. Vaginal misoprostol for cervical ripening and induction of labour. Cochrane Database Syst Rev, 2010, 10, CD000941.

31. Howarth, GR., Botha, DJ. Amniotomy plus intravenous oxytocin for induction of labour. Cochrane Database Syst Rev, 2001, 3, CD003250.

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34. Jozwiak, M., Bloemenkamp, KWM., Kelly, AJ., et al. Mechanical methods for induction of labour. Cochrane Database Syst Rev, 2012, 3, CD001233.

35. Kelly, AJ., Malik, S., Smith, L., et al. Vaginal prostaglandin for induction of labour at term. Cochrane Database Syst Rev, 2009, 4, CD003101.

36. Kelly, AJ., Alfirevic, Z., Dowswell, T. Outpatient versus inpatient induction of labour for improving birth outcomes. Cochrane Database Syst Rev, 2009, 2, CD007372.

37. Kundodyiva, TW., Alfirevic, Z., Weeks, AD. Low-dose oral misoprostol for induction of labor a systematic review. Obstet Gynecol, 2009, 113, p. 374–383.

38. Landon, MB., Hauth, JC., Leveno, KJ., et al. Maternal and perinatal outcomes associated with a trial of labour after prior caesarean delivery. NEJM, 2004, 351, p. 2581–2589.

39. Liston, R., Sawchuck, D., Young, D. Fetal health surveillance: antepartum and intrapartum consensus guideline 2007. SOGC Clinical Practice Guidelines, No. 197, J Obstet Gynaecol Can, 2007, 29, p. S3–S36.

40. Lydon-Rochelle, MT., Cárdenas, V., Nelson, JC., et al. Induction of labor in the absence of standard medici indications. Med Care, 2007, 45, p. 505–512.

41. Macones, GA., Hankins, GD., Spong, CY., et al. The 2008 National Institute of Child Health and Human Development workshop report on electronic fetal monitoring: update on definitions, interpretation, and research guidelines. Obstet Gynecol, 2008, 112, p. 661–666.

42. Mariani Neto, C., Leao, EJ., Baretto, EM., et al. Use of misoprostol for labour induction in stillbirths. Rev Paul Med, 1987, 105, p. 325–328.

43. Miranda de, E., van der Bom, J., Bonsel, G., et al. Membrane sweeping and prevention of post-term pregnancy in low-risk pregnancies: a randomised controlled trial. BJOG, 2006, 113, p. 402–408.

44. Mishanina, E., Rogozinska, E., Thatthi, T., et al. Use of labour induction and risk of caesarean delivery: a systematic review and meta-analysis. Can Med Assoc J, 2014, 186 (9), p. 665–673.

45. Mozurkewich, E., Chilimigras, J., Koepke, E., et al. Indications for induction of labour: a best-evidence review. BJOG, 2009, 116, p. 626–636.

46. Neilson, JP. Ultrasound for fetal assessment in early pregnancy. Cochrane Database Syst Rev, 1998, 4, CD000182.

47. NICE Induction of labour, July 2013, NICE quality standard 70,

48. NICE Hypertension in pregnancy, July 2013, NICE quality standard 35,

49. Osterman, MJ., Martin, JA. Recent declines in induction of labor by gestational age. NCHS Data Brief, 2014.

50. Pennell, C., Henderson, J., O‘Neill, M., et al. Induction of labor in nulliparous women with an unfavourable cervix: a randomised controlled trial comparing double and single balkon catheters and PGE2 gel. BJOG, 2009, 116, p. 1443–1452.

51. Peregrine, E., O‘Brien, P., Omar, R., Jauniaux, E. Clinical and ultrasound parameters to predict the risk of cesarean delivery after induction of labor. Obstet Gynecol, 2006, 107, p. 227–233.

52. Public Health Agency of Canada. BC Reproductive Care Program (BCRCP). Ottawa: Public Health Agency of Canada, 2005.

53. Queensland Clinical Guidelines: Induction of labour, January 2014, p. 1–26.

54. RCOG recommendation: Induction of labour at term in older mothers, February 2013, Scientic Impact Paper No. 34.

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56. Roztočil, A., Pilka, L., Jelínek, J., et al. A comparison of three preinduction cervical priming methods: Prostaglandin E2 gel, Dilapan S rods, and Estradiol gel. Čes Gynek, 1998, 63, s .3–9.

57. Saleh, M., Abdo, K. Intrahepatic cholestasis of pregnancy: a review of the literature and evaluation of current evidence. J Wom Health, 2007, 16, p. 833–841.

58. Selo-Ojeme, DO., Pisal, P., Lawal, O., et al. A randomized controlled trial of amniotomy and immediate oxytocin infusion versus amniotomy and delayed oxytocin infusion for induction of labour at term. Arch Gynecol Obstet, 2009, 279, 6, p. 813–820.

59. Smith, JG., Merrill, DC. Oxytocin for induction of labor. Clin Obstet Gynecol, 2006, 49, p. 594–608.

60. SOGC clinical practice guidelines: Diagnosis, evaluation and management of the hypertensive disorders of pregnancy. J Obstet Gynecol Can, 2008, 30, S1.

61. SOGC clinical practice guidelines: Induction of labour. J Obstet Gynecol Can, 2013, 296, p. S1–S18.

62. Takahashi, T., Marcus, B., Scheerer, RG., Katz, M. A new model for objective assessment of cervical ripening: the effect of prostaglandin E2 and prelabor contractility. Am J Obstet Gynecol, 1991, 164, p. 1115–1118.

63. Tang, J., Kapp, N., Dragoman, M., de Souza, JP. WHO recommendations for misoprostol use for obstetrics and gynecologic indications. Int J Gynecol Obstet, 2013, p. 224–228.

64. Towers, CV., Briggs, GG., Rojas, JA. The use of prostaglandin E2 in pregnant patients with asthma. Am J Obstet Gynecol, 2004, 190, p. 1777–1781.

65. ÚZIS: Zpráva o rodičce, zpráva o novorozenci.

66. Vlk, R., Hruban, L., Janků, P., Šimetka, O., et al. Efficacy and safety of the osmotic dilator Dilapan-S for cervical ripening in women with/without Caesarean section. 13rd World Congress in Fetal Medicine, June 2014, Nice, France.

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69. Yildirim, G., Güngördük, K., Karadağ, OI., et al. Membrane sweeping to induce labor in low-risk patients at term pregnancy: a randomised controlled trial. J Matern Fetal Neonat Med, 2009, 23, p. 681–687.

70. Zwart, J., Richters, JM., Ory, F., et al. Uterine rupture in the Netherlands: a nationwide population-based cohort study. BJOG, 2009, 116, p. 1069–1080.

Paediatric gynaecology Gynaecology and obstetrics Reproduction medicine
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