Abstract
Induction of labor is a common obstetric procedure performed in nearly a quarter of
all deliveries in the United States. Pharmacological (prostaglandins, oxytocin) and/or
mechanical methods (balloon catheters) are commonly used for labor induction; however,
there is ongoing debate as to which method is the safest and most effective. This
narrative review discusses key limitations of published trials on labor induction,
including the lack of well-designed randomized controlled trials directly comparing
specific methods of induction, heterogeneous trial populations, and wide variation
in the protocols used and outcomes reported. Furthermore, the majority of published
trials were underpowered to detect significant differences in the most clinically
relevant efficacy and safety outcomes (e.g., cesarean delivery, neonatal mortality).
By identifying the limitations of labor induction trials, we hope to highlight the
importance of quality published data to better inform guidelines and drive evidence-based
treatment decisions.
Keywords
labor induction - prostaglandins - dinoprostone - misoprostol - oxytocin - clinical
trials
