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Guidelines for Induction of Labor in Prolonged Pregnancy

From the Department of Obstetrics and Gynecology, Hospital das CIínicas, So Paulo, Brazil

Abstract

Induction of labor was studied retrospectively in two groups, one consisting of 69 women who had been pregnant for 290 days or less and the other of 70 women who had been pregnant for longer periods. In prolonged pregnancy the cervix uteri was characteristically unripe, which unduly extended the induction-to-delivery time. There was also a high failure of induction, more functional dystocia and fetal distress, and a greater incidence of cesarean section (27%, compared with only 7%). Infants were heavier but were otherwise as healthy. The authors conclude that in prolonged pregnancy watchful waiting is generally indicated until the cervix is ripe, when induction may be performed if labor has not begun and there is no evidence of fetal postmaturity, placental dysfunction, or cephalopelvic disproportion. Fetal distress and toxemia are indications for cesarean section, not induction.