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Outpatient Approaches to Elective Induction of Labor: Past, Present, and Future

RAUF, ZUBAIR MBBS*; ALFIREVIC, ZARKO MD, MPP, MPH, PhD

Clinical Obstetrics & Gynecology: June 2014 - Volume 57 - Issue 2 - p 391–400
doi: 10.1097/GRF.0000000000000028
Elective Induction of Labor

Assessing the feasibility, acceptability and safety of outpatient labour induction. MEDLINE database was searched for “outpatient labor induction” from January 1, 1986 to February 28, 2013. Main outcomes of interest included hyperstimulation, cesarean births, Apgar scores <7 at 5 minutes, arterial-cord pH of <7.10, and neonatal morbidity/mortality. Overall cesarean rates vary significantly (2.6% to 42%). Hyperstimulation with CTG changes is rare. Neonatal admissions for diverse reasons are often not associated with outpatient induction agent. Overall, maternal satisfaction is high. Outpatient labor induction is feasible and important adverse events are rare. However, paucity of available data and heterogeneity of different studies make it difficult to quantify adverse events or identify a preferred induction method.

Departments of *Obstetrics and Gynecology

Women’s and Children’s Health, University Department, Liverpool Women’s Hospital, Institute of Translational Medicine, University of Liverpool, Liverpool, UK

Supported by previous unrestricted educational grant to University of Liverpool provided jointly by Ferring Pharmaceuticals and Monica Healthcare limited for the study “Home labour induction with retrievable prostaglandin pessary and continuous telemetric trans-abdominal fetal ECG monitoring.”

The authors declare that they have nothing to disclose.

Correspondence: Zarko Alfirevic, MD, MPP, MPH, PHD, Department of Women’s and Children’s Health, University Department, Liverpool Women’s Hospital, Institute of Translational Medicine, University of Liverpool, Crown Street, Liverpool L8 7SS, UK. E-mail: zarko@liverpool.ac.uk

© 2014 by Lippincott Williams & Wilkins.