A Systematic Review of Implementing an Elective Labor Induction Policy

摘要

Objective: To evaluate the effect of implementing hospital policies aimed at reducing elective labor induction and increasing spontaneous labor rates.Data Sources: PubMed, CINAHL, Cochrane Database of Systematic Reviews, and Dissertation Abstracts International.Study Selection: Observational studies published from 2000 to 2010 were the only original studies from the past 20 years that met the review criteria. These focused on elective induction, labor induction policies, pre- and postimple-mentation of labor induction policy outcomes, and cesarean and maternaleonatal morbidity rates.Data Extraction: Six retrospective and three prospective observational studies regarding implementation of labor induction policies were reviewed for types of intervention guidelines implemented and outcomes on rates of induction, cesarean, and maternaleonatal morbidity.Data Synthesis: Implementation of elective induction policies resulted in lower induction, cesarean, operative/instrumental vaginal delivery, and maternaleonatal morbidity rates. Patients spontaneously gave birth before scheduled elective induction date after policies were implemented, thereby resulting in lower rates of elective induction.Conclusions: Elective labor induction policies should be developed and implemented in all labor and delivery units.