A systematic scoping review of clinical indications for induction of labour

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Abstract

Background

The proportion of women undergoing induction of labour (IOL) has risen in recent decades, with significant variation within countries and between hospitals. The aim of this study was to review research supporting indications for IOL and determine which indications are supported by evidence and where knowledge gaps exist.

Methods

A systematic scoping review of quantitative studies of common indications for IOL. For each indication, we included systematic reviews/meta-analyses, randomised controlled trials (RCTs), cohort studies and case control studies that compared maternal and neonatal outcomes for different modes or timing of birth. Studies were identified via the databases PubMed, Maternity and Infant Care, CINAHL, EMBASE, and ClinicalTrials.gov from between April 2008 and November 2019, and also from reference lists of included studies. We identified 2554 abstracts and reviewed 300 full text articles. The quality of included studies was assessed using the RoB 2.0, the ROBINS-I and the ROBIN tool.

Results

68 studies were included which related to post-term pregnancy (15), hypertension/pre-eclampsia (15), diabetes (9), prelabour rupture of membranes (5), twin pregnancy (5), suspected fetal compromise (4), maternal elevated body mass index (BMI) (4), intrahepatic cholestasis of pregnancy (3), suspected macrosomia (3), fetal gastroschisis (2), maternal age (2), and maternal cardiac disease (1). Available evidence supports IOL for women with post-term pregnancy, although the evidence is weak regarding the timing (41 versus 42 weeks), and for women with hypertension/preeclampsia in terms of improved maternal outcomes. For women with preterm premature rupture of membranes (24–37 weeks), high-quality evidence supports expectant management rather than IOL/early birth. Evidence is weakly supportive for IOL in women with term rupture of membranes. For all other indications, there were conflicting findings and/or insufficient power to provide definitive evidence.

Conclusions

While for some indications, IOL is clearly recommended, a number of common indications for IOL do not have strong supporting evidence. Overall, few RCTs have evaluated the various indications for IOL. For conditions where clinical equipoise regarding timing of birth may still exist, such as suspected macrosomia and elevated BMI, researchers and funding agencies should prioritise studies of sufficient power that can provide quality evidence to guide care in these situations.

Related collections

Most cited references 178

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Guidance for conducting systematic scoping reviews.

Micah D.J. Peters, Christina M Godfrey, Hanan Khalil … (2015)

Reviews of primary research are becoming more common as evidence-based practice gains recognition as the benchmark for care, and the number of, and access to, primary research sources has grown. One of the newer review types is the 'scoping review'. In general, scoping reviews are commonly used for 'reconnaissance' - to clarify working definitions and conceptual boundaries of a topic or field. Scoping reviews are therefore particularly useful when a body of literature has not yet been comprehensively reviewed, or exhibits a complex or heterogeneous nature not amenable to a more precise systematic review of the evidence. While scoping reviews may be conducted to determine the value and probable scope of a full systematic review, they may also be undertaken as exercises in and of themselves to summarize and disseminate research findings, to identify research gaps, and to make recommendations for the future research. This article briefly introduces the reader to scoping reviews, how they are different to systematic reviews, and why they might be conducted. The methodology and guidance for the conduct of systematic scoping reviews outlined below was developed by members of the Joanna Briggs Institute and members of five Joanna Briggs Collaborating Centres.

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Beyond too little, too late and too much, too soon: a pathway towards evidence-based, respectful maternity care worldwide.

Suellen Miller, Edgardo Abalos, Monica Chamillard … (2016)

On the continuum of maternal health care, two extreme situations exist: too little, too late (TLTL) and too much, too soon (TMTS). TLTL describes care with inadequate resources, below evidence-based standards, or care withheld or unavailable until too late to help. TLTL is an underlying problem associated with high maternal mortality and morbidity. TMTS describes the routine over-medicalisation of normal pregnancy and birth. TMTS includes unnecessary use of non-evidence-based interventions, as well as use of interventions that can be life saving when used appropriately, but harmful when applied routinely or overused. As facility births increase, so does the recognition that TMTS causes harm and increases health costs, and often concentrates disrespect and abuse. Although TMTS is typically ascribed to high-income countries and TLTL to low-income and middle-income ones, social and health inequities mean these extremes coexist in many countries. A global approach to quality and equitable maternal health, supporting the implementation of respectful, evidence-based care for all, is urgently needed. We present a systematic review of evidence-based clinical practice guidelines for routine antenatal, intrapartum, and postnatal care, categorising them as recommended, recommended only for clinical indications, and not recommended. We also present prevalence data from middle-income countries for specific clinical practices, which demonstrate TLTL and increasing TMTS. Health-care providers and health systems need to ensure that all women receive high-quality, evidence-based, equitable and respectful care. The right amount of care needs to be offered at the right time, and delivered in a manner that respects, protects, and promotes human rights.

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Labor Induction versus Expectant Management in Low-Risk Nulliparous Women

Annette Perez-Delboy, George Saade, Madeline M. Rice … (2018)

The perinatal and maternal consequences of induction of labor at 39 weeks among low-risk nulliparous women are uncertain.

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Author and article information

Contributors

Dominiek Coates:

ORCID: http://orcid.org/0000-0002-4463-7615

Role: ConceptualizationRole: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: Project administrationRole: SupervisionRole: Writing – original draftRole: Writing – review & editing

Angela Makris: Role: Data curationRole: Funding acquisitionRole: InvestigationRole: MethodologyRole: ValidationRole: Writing – original draftRole: Writing – review & editing

Christine Catling: Role: Data curationRole: InvestigationRole: MethodologyRole: Writing – original draftRole: Writing – review & editing

Amanda Henry: Role: ConceptualizationRole: Funding acquisitionRole: MethodologyRole: ValidationRole: Writing – review & editing

Vanessa Scarf: Role: Data curationRole: InvestigationRole: MethodologyRole: Writing – original draftRole: Writing – review & editing

Nicole Watts: Role: Data curationRole: InvestigationRole: Project administrationRole: Writing – original draftRole: Writing – review & editing

Deborah Fox: Role: Data curationRole: InvestigationRole: MethodologyRole: Writing – original draftRole: Writing – review & editing

Purshaiyna Thirukumar: Role: Data curationRole: Project administrationRole: Writing – review & editing

Vincent Wong: Role: Data curationRole: Writing – original draftRole: Writing – review & editing

Hamish Russell: Role: Data curationRole: Writing – original draftRole: Writing – review & editing

Caroline Homer: Role: ConceptualizationRole: Data curationRole: Funding acquisitionRole: MethodologyRole: Project administrationRole: SupervisionRole: Writing – review & editing

Salvatore Andrea Mastrolia: Role: Editor

Journal

Journal ID (nlm-ta): PLoS One

Journal ID (iso-abbrev): PLoS ONE

Journal ID (publisher-id): plos

Journal ID (pmc): plosone

Title: PLoS ONE

Publisher: Public Library of Science (San Francisco, CA USA )

ISSN (Electronic): 1932-6203

Publication date (Electronic): 29 January 2020

Publication date Collection: 2020

Volume: 15

Issue: 1

Electronic Location Identifier: e0228196

Affiliations

[1 ] Centre for Midwifery and Child and Family Health, Faculty of Health, University of Technology Sydney, Australia

[2 ] Department of Medicine, Western Sydney University, Sydney, Australia

[3 ] Women’s Health Initiative Translational Unit (WHITU), Liverpool Hospital, Liverpool, Australia

[4 ] School of Women’s and Children’s Health, UNSW Medicine, University of New South Wales, Sydney, Australia

[5 ] Department of Women’s and Children’s Health, St George Hospital, Sydney, Australia

[6 ] The George Institute for Global Health, UNSW Medicine, Sydney, Australia

[7 ] Liverpool Diabetes Collaborative Research Unit, Ingham Institute of Applied Research Science, University of New South Wales, Liverpool, Australia

[8 ] South Western Sydney Local Health District, Sydney, Australia

[9 ] Maternal and Child Health Program, Burnet Institute, Victoria, Australia

Ospedale dei Bambini Vittore Buzzi, ITALY

Author notes

Competing Interests: The authors have declared that no competing interests exist.

* E-mail: Dominiek.Coates@ 123456uts.edu.au

Author information

Dominiek Coates http://orcid.org/0000-0002-4463-7615

Article

Publisher ID: PONE-D-19-15778

DOI: 10.1371/journal.pone.0228196

PMC ID: 6988952

PubMed ID: 31995603

SO-VID: 5b7acb5b-b076-49eb-bba2-8fc7c8a25f17

License:

This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

History

Date received : 5 June 2019

Date accepted : 10 January 2020

Page count

Figures: 1, Tables: 3, Pages: 42

Funding

Funded by: National Health and Medical Research Council

Award Recipient : Caroline Homer

Funded by: funder-id http://dx.doi.org/10.13039/501100000925, National Health and Medical Research Council;

Award Recipient : Amanda Henry

Funded by: Sydney Partnership for Health, Education, Research and Enterprise (SPHERE)

Award Recipient : Caroline Homer

DC was supported by funding from Maridulu Budyari Gumal, the Sydney Partnership for Health, Education, Research and Enterprise (SPHERE) as part of the Timing of Birth study - https://www.thesphere.com.au/. CH was supported by a National Health and Medical Research Council (NHMRC) Research Fellowship. AH was supported by a National Health and Medical Research Council (NHMRC) Early Career Fellowship https://www.nhmrc.gov.au/. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Custom metadata

Data Availability All relevant data are within the manuscript and its Supporting Information files.