Corticosteroids for cervical ripening and induction of labour.

BACKGROUND

The role of corticosteroids in the process of labour is not well understood. Animal studies have shown the importance of cortisol secretion by the fetal adrenal gland in initiating labour in sheep. Infusion of glucocorticosteroids into the fetus has also shown to induce premature labour in sheep. Given these studies it has been postulated that corticosteroids will promote the induction of labour in women. This is one of a series of reviews of methods of cervical ripening and labour induction using standardised methodology.

OBJECTIVES

To determine the effects of corticosteroids for third trimester cervical ripening or induction of labour in comparison with other methods of cervical priming or induction of labour.

SEARCH STRATEGY

We searched the Cochrane Pregnancy and Childbirth Group Trials Register (December 2005) and bibliographies of relevant papers.

SELECTION CRITERIA

Clinical trials of corticosteroids for third trimester cervical ripening or labour induction.

DATA COLLECTION AND ANALYSIS

A strategy was developed to deal with the large volume and complexity of trial data relating to labour induction. This involved a two-stage method of data extraction. We assessed trial quality. We contacted study authors for additional information. We collected adverse effects information from the trials.

MAIN RESULTS

Only one small trial (66 women) was included. The primary outcome vaginal birth within 24 hours was not reported. No benefit of intramuscular administration of corticosteroids with intravenous oxytocin was found when compared with oxytocin alone. However, given the small size of this trial this result should be interpreted cautiously.

AUTHORS' CONCLUSIONS: The effectiveness of corticosteroids for induction of labour is uncertain. This method of induction of labour is not commonly used and so further research in this area is probably unwarranted.