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Use and Misuse of the Term “Elective” in Obstetrics

Berghella, Vincenzo MD; Blackwell, Sean C. MD; Ramin, Susan M. MD; Sibai, Baha M. MD; Saade, George R. MD

doi: 10.1097/AOG.0b013e31820780ff
Current Commentary

The term ”elective” is commonly used in obstetrics. We performed an electronic search of MEDLINE database using the terms “elective” and “obstetrics,” which provided 2,208 publications. We found “elective” was more often used in relation to surgical interventions (eg, cesarean delivery, cerclage) and medical procedures (labor induction) rather than diagnostic procedures. Our review indicates the term lacks the necessary scientific specificity when used to modify procedures such as cerclage, cesarean delivery, timing of delivery, episiotomy, hysterectomy, labor induction, preterm delivery, termination of pregnancy, and ultrasonography. The lack of specificity of the term suggests the most reasonable and prudent course of action is to not use it, but rather to document the specific indication (whether medical or non-medical) for the intervention or procedure (eg, “cesarean delivery on maternal request,” “history-indicated cerclage,” “induction for preeclampsia”). We propose that the term “elective” should be eliminated from the vocabulary of obstetric practice.

The term “elective” should be eliminated from the vocabulary of obstetric practice.

From the Department of Obstetrics and Gynecology, Thomas Jefferson University, Philadelphia, Pennsylvania; Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Texas Health Science Center at Houston, Houston, Texas; Department of Obstetrics and Gynecology, University of Cincinnati, Cincinnati, Ohio; Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas.

Corresponding Author: Vincenzo Berghella, MD, Thomas Jefferson University, 834 Chestnut Street, Suite 400, Philadelphia, PA 19107; e-mail:

Financial Disclosure The authors did not report any potential conflicts of interest.

© 2011 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.