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Conference Talk
Induction of Labour Session Patrick Obrien
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Both induction of labour and Caesarean section rates have increased significantly. A systematic review and meta-analysis of trials in women with intact membranes by Wood et al showed that induction of labour reduces Caesarean section in comparison with expectant treatment. Another meta-analysis by Kate Walker et al showed that induction of labour has no statistically significant effect on Caesarean section. Dr. O’Brien discusses the various indications for induction of labour, pros and cons for induction of labour in macrosomia and advantages of planned early birth vs expectant line of management for pre labour rupture of membranes at term. The methods for induction of labour and the timing (morning vs evening), the place (outpatient vs. inpatient) for improving outcomes are discussed in detail. NICE quality standards for induction of labour involve personalized information to patients regarding benefits and risks and alternatives to induction of labour. Pain relief, availability of safety and support procedures and audit are important considerations.

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