Minimizing the risks from elective induction of labor.

A systematic review of the literature was performed on the risks associated with elective induction of labor. A MEDLINE search was undertaken of articles based on the criterion that elective induction was central to the article. Manuscripts were in English in core clinical journals from 1996 to 2005. Articles before 1996 were included if they added historical information relevant to the topics. Despite not being evidence based, elective inductions are becoming more acceptable and account for approximately 10% of deliveries. A high cesarean rate for nulliparas is the most undesired effect when undergoing induction with an unfavorable cervix. A longer intrapartum course can overutilize resources. Until larger, prospective clinical trials are performed, it will be difficult to evaluate the impact of the elective induction of labor on populationwide cesarean delivery rates. More attention should be directed toward whether the experience of elective induction is satisfactory to the patient, obstetrician and intrapartum crew.