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Non-hormonal methods for induction of labour

Lim, Chi Eung Danforn; Ng, Rachel Wai Chung; Xu, Ke

Current Opinion in Obstetrics and Gynecology: December 2013 - Volume 25 - Issue 6 - p 441–447
doi: 10.1097/GCO.0000000000000027
WOMEN'S HEALTH: Edited by Joseph Aquilina

Purpose of review The percentage of induced live birth has more than doubled from the 1990s to 2008. Induction of labour can either be based on medical indications, or performed as an elective procedure. A large range of pharmacological and non-pharmacological modalities are available for the induction of labour and the optimal method for labour induction is unknown. This article is aimed to examine literature on non-hormonal methods for labour induction, published from January 2012 to May 2013.

Recent findings Eleven studies were identified in our search and included into the review. Foley balloon catheter appears to be more cost-effective and commonly used non-hormonal technique for induction of labour, although further meta-analysis is required in this area. Currently, there is not enough evidence to support routine use in all women for labour induction among other methods including amniotomy, acupuncture, sexual intercourse, isosorbide mononitrate, hypnosis, castor oil and breast stimulation. The latest three studies suggest that amniotomy may increase need for oxytocin augmentation during labour induction.

Summary Many non-hormonal methods for labour induction still require further evidence to support their use within the clinical setting. Balloon catheter seems to be a more widely accepted non-hormonal method that has been supported by various literatures.

Faculty of Medicine, University of New South Wales, Sydney Australia

Correspondence to Dr Chi Eung Danforn Lim, MBBS, PhD, MMed, MAppSc, MAppMgt (Health), BSc, BHltSc, DCH, ClinDipPallMed, Conjoint Appointee, PO Box 3256, Blakehurst, NSW 2221, Australia. Tel: +61 412280925; fax: +61 2 95473081; e-mail:

© 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins