Does induction of Labor Increase the Risk for Cesarean Section?: A Systematic Review and Meta-analysis of Trials in Women With Intact Membranes

摘要

Rising rates of cesarean delivery are a major concern for all medical professionals. Reducing the frequency of induction is often mentioned as a means to reverse this trend. Published studies and review articles have examined induction of labor (IOL) versus expectant management and the risk for cesarean delivery, with conflicting results. This systematic review and meta-analysis was performed to determine whether IOL compared with expectant management in women with intact membranes increased the rate of cesarean delivery. MEDLINE, EMB ASE, and the Cochrane Database of Clinical Trials were searched. Studies were included if IOL, for indications other than premature rupture of membranes, was compared with expectant management and outcome data on route of delivery were provided. Quantitative analyses with fixed- and random-effects models were performed.