Induction of Labor in Nulliparous Patients
Induction of labor occurs in approximately 22% of all deliveries in the United States. Induction of labor is valuable when the benefits of delivery outweigh the risks of continuing the pregnancy. Recent data has shown a possible benefit to elective induction after 39 weeks when performed in a standardized fashion. The benefits of induction should be weighed against the potential maternal and/or fetal risks. Increasing rates of labor induction are associated with increased risks for cesarean deliveries, preterm birth, and NICU admissions if proper guidelines are not used.
Patients with labor induction utilize Labor & Delivery beds longer than spontaneously laboring patients. Therefore, prior to initiating an induction, the provider should review the indications, risks and benefits, and the necessity of the induction. When elective induction is considered a collaborative discussion between the patient and provider is imperative to review expectations and understand infrastructure limitations if any. If induction of labor is necessary and the Bishop Score is less than 7, cervical ripening is recommended.
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