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Induction of labor
Guidelines
Key sources
The following summarized guidelines for the evaluation and management of induction of labor are prepared by our editorial team based on guidelines from the American Academy of Family Physicians (AAFP 2024), the American College of Obstetricians and Gynecologists (ACOG 2024), the Society of Obstetricians and Gynaecologists of Canada (SOGC 2023), the World Health Organization (WHO 2022,2014), the Austrian Society of ...
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Classification and risk stratification
Diagnostic investigations
Confirmation of fetal presentation: as per SOGC 2023 guidelines, conform fetal presentation by abdominal examination and/or ultrasound before labor induction.
A
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Digital vaginal examination
Medical management
Setting of care: as per WHO 2022 guidelines, do not offer routine outpatient induction of labor for improving birth outcomes.
D
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Indications for induction of labor
Oxytocin
Prostaglandins
Inpatient care
Monitoring of induction: as per WHO 2014 guidelines, obtain an active phase partogram with a 4-hour action line for monitoring the progress of labor.
B
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Electronic fetal monitoring
Nonpharmacologic interventions
Activity and positioning: as per WHO 2014 guidelines, encourage adopting mobility and upright position during labor in patients at low risk.
B
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Food intake
Companionship
Membrane sweeping
Alternative therapies
Therapeutic procedures
Balloon catheter
As per WHO 2022 guidelines:
Offer balloon catheter for induction of labor.
B
Offer the combination of balloon catheter plus oxytocin administration for induction of labor.
B
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Cervical dilators
Neuraxial anesthesia
Surgical interventions
Amniotomy: as per ACOG 2024 guidelines, perform amniotomy in patients undergoing induction of labor to reduce the duration of labor.
A
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Cesarean delivery
Patient education
General counseling: as per SOGC 2023 guidelines, decide on the induction of labor through a shared decision-making process between the pregnant individual and the care provider, with respect for an individual's choice. Document the consent discussion including the benefits and risks of both induction and expectant management, along with the induction process, including methods, timing, and how these may affect the patient and fetus.
B