| | How to avoid iatrogenic morbidity and mortality while increasing availability of oxytocin and misoprostol for PPH prevention? published online 27 October 2008. Abstract ObjectiveIncreased availability of oxytocin and misoprostol is needed to reduce the risk of postpartum hemorrhage. This review compiles rates and risks of adverse maternal and perinatal outcomes associated with use of these medications for labor induction and augmentation in low-income countries. Recommendations are proposed based on the findings. MethodsWe did a structured literature review using 5 databases followed by analysis of induction and augmentation rates from existing data. ResultsCombined induction and augmentation rates were documented in up to 50% of hospital-based deliveries identified in the databases. Data are sparse but suggest associations between induction/augmentation and stillbirth, neonatal resuscitation, and uterine rupture, and inappropriate administration of oxytocin and misoprostol both outside and inside healthcare systems in low-income countries. ConclusionsGuidelines for labor induction/augmentation are needed specifically for low resourced settings. Rigorous studies should be pursued to quantify the magnitude and effect of inappropriate induction and augmentation on maternal and perinatal morbidity and mortality. Programs are needed to ensure community-wide awareness of the adverse effects of the improper use of these drugs on mothers and babies, especially in out-of-hospital settings. 1. Context  To address postpartum hemorrhage, international agencies have called for expanded availability of oxytocin and misoprostol, particularly to peripheral level health centers, to help ensure routine active management of the third stage of labor (AMTSL) for all facility-based deliveries. Studies assessing the effectiveness of oral misoprostol at reducing postpartum hemorrhage in home-based deliveries have also shown promising results [1]. Appropriate packaging of misoprostol for obstetric use is increasingly available in low-income countries [2]. However, this welcome expansion in the availability of uterotonic drugs also carries risk of elective or improper administration of these drugs for labor induction and augmentation. For decades, this concern has retarded increased availability and was the impetus for the current literature review of rates, trends, and maternal and perinatal adverse outcomes associated with labor induction and augmentation in low-income countries. Cervical ripening, induction, and augmentation of labor all involve the use of uterotonic drugs. The gold standard for induction protocols in low-income countries is cervical ripening with a vaginal prostaglandin such as Prostin E2 (Pfizer; New York, USA) or dinoprostone, followed, if needed, by induction or augmentation with intravenous oxytocin and incorporating artificial rupture of the membranes depending on the woman's clinical condition [3], [4], [5], [6]. These procedures are considered significant obstetric interventions and should only be used for valid indications in facilities where there is immediate access to cesarean delivery and appropriate maternal and perinatal monitoring [3], [4], [5], [6]. In high-income country settings, induction and augmentation are carried out using a regulatory infusion pump and the fetus is continuously monitored using an electronic fetal monitor [3], [4], [5], [6]. Without a regulatory infusion pump, use of any intramuscular oxytocic before delivery is regarded as dangerous because the dosage may be too high and cannot be adjusted to the level of uterine activity [6]. Hyperstimulation of the uterus may result and can lead to uterine rupture, fetal asphyxia or fetal death [7], [8]. Induction and augmentation are safe and generally have good outcomes where there are adequate guidelines, training, monitoring capabilities, equipment, and staffing. The risk of cesarean delivery is higher with elective labor induction than with spontaneous labor. This is the most consistent adverse outcome documented in the literature [9], [10], [11], [12], [13], [14], [15]. Medically appropriate indications for induction include intrauterine growth restriction of the fetus, uncontrolled hypertension [16], [17], and post-date pregnancy. However, the findings of a large randomized control trial in 1992 introduced controversy over the most appropriate time to induce when it showed better outcomes for women induced at 41 weeks compared with women induced later [18]; some argue that induction at 41 weeks should be considered elective induction [19], [20], [21], [22]. Unfortunately, the terms induction and augmentation of labor and cervical ripening are often used interchangeably in the literature, despite important differences in their definitions, indications, risks, and outcomes. For example, cervical ripening often precedes spontaneous onset of labor, and is then referred to as induction; oxytocin induction is often accompanied by artificial rupture of the membranes, though this nonpharmacological method may not be mentioned; spontaneous labor following cervical ripening and then subsequent augmentation is often referred to simply as induction; and labor induction following rupture of membranes is sometimes referred to as augmentation. Although the benefits associated with the use of uterotonics are firmly established in the third stage of labor [23], [24], [25], the frequency with which they should be used for labor induction and augmentation is controversial in low-income country settings where oxytocin, ergometrine, and in some cases, misoprostol are likely to be the only uterotonic drugs available, current evidence-based guidelines are rare, care is less regulated, and staffing and monitoring capabilities are limited [26], [27], [28], [29], [30], [31]. Oxytocin is often administered without the aid of a precise dose/time regulatory infusion pump, external fetal monitor (EFM) or one-on-one care [32], [33], [34], [35]. Where misoprostol is available, it is packaged most commonly as 100 or 200 μg tablets, which must be divided manually or dissolved and measured for purposes of induction [36], [37]. Improper dosing, administration, and monitoring may lead to administration of excessive amounts of oxytocin or misoprostol, which can lead to hyperstimulation of the uterus and its sequelae. 2. Objectives This paper has 2 objectives: (1) to summarize current rates, trends, and risks associated with labor induction and augmentation with oxytocin and/or misoprostol in low-income countries; and (2) to make specific recommendations regarding the expanding availability of uterotonic drugs in low-income countries. 3. Methods We compiled rates of induction and augmentation from 2 sources: (1) analysis of data on induction and augmentation from a 7-country study of AMTSL; and (2) a structured review of the published literature. The literature review used broad search terms to identify rates, trends, and adverse maternal and perinatal outcomes associated with induction and augmentation. Search terms are available on request. Maternal and perinatal adverse outcomes include: cesarean delivery, hyperstimulation of the uterus, uterine rupture, maternal mortality, fetal hypoxia, and significant morbidity as indicated by a 5-minute Apgar score less than 7 or admission to the neonatal intensive care unit (NICU), and perinatal mortality. Five databases were searched: PubMed, CINAHL plus, Embase, Scopus, and the Cochrane Library. Articles were included if they were published from 1988 to October 2007, and were excluded if they focused on induction or augmentation for preterm births, history of previous cesarean delivery, multiple gestation, and macrosomia. Articles addressing misoprostol use for induction and augmentation were included if they were published from 2004 to December 2007. Definitive systematic reviews published in 2004 showed that adverse maternal and perinatal outcomes were associated with doses greater than 50 μg of misoprostol. Therefore, research published before this date was eliminated when lower doses of 25 μg per vagina or 50 μg orally every 4 hours were used [30], [36], [38], [39]. The Cochrane database was searched for meta-analyses of induction and augmentation. Randomized controlled trials included in those Cochrane reviews were not reviewed individually. The searches identified 962 articles from 5 databases; 278 references remained following review of the abstract, and 140 references met the inclusion/exclusion criteria following full review of the article. Further details of the literature review are published elsewhere [40]. 4. Results 4.1. Rates Rates of induction and augmentation from low-income countries are available from nationally representative samples of public facilities, predominantly hospital-based deliveries in 7 countries (Table 1) and from the literature (Table 2). The data in Table 1 refer to deliveries in mostly district level or higher hospitals, although the 3 sub-Saharan African samples include health center-based deliveries. As shown in Table 1, the representativeness of these samples varies according to the institutional birth rate. The sample in Tanzania represents 61% of facility-based births; the Benin, Ethiopia, Nicaragua, and Honduras samples represent between 80% and 92% of facility-based births; and in Indonesia, where many institutional births occur in the private sector, the sample represents 16% of facility-based births. Data on place of delivery were not available for El Salvador. A detailed description of sample design for these countries is described elsewhere [41]. | | |  | Country, Reference year | % of all births that occur in the types of facilities included in the AMTSL sample | % of all health facility-based births that occur in the types of health facilities included in the AMTSL sample | Induced (%) | Augmented only (%) | Neither (%) | Total | No. of observed deliveries | |
|---|
| Benin, 2006 | 58.3 | 89.9 | 3.2 | 37.9 | 58.9 | 100.0 | 250 | | | Ethiopia, 2005 | 4.4 | 91.7 | 0.5 | 11.9 | 87.6 | 100.0 | 310 | | | Tanzania, 2005 | 23.0 | 60.7 | 8.3 | 8.7 | 83.0 | 100.0 | 249 | | | Indonesia, 2006 | 6.2 | 15.6 | 25.5 | 18.3 | 56.2 | 100.0 | 408 | | | El Salvador, 2006 | na | na | 22.6 | 18.8 | 58.6 | 100.0 | 192 | | | Honduras, 2006 | 49.0 | 80.0 | 10.5 | 32.3 | 57.2 | 100.0 | 221 | | | Nicaragua, 2006 | 51.7 | 86.5 | 17.1 | 32.1 | 50.8 | 100.0 | 180 | | | | |
| | | | Author/year | Country | Data collection year | Rate of induced labor (%) | Denominator | |
|---|
| Loto et al. [43] | Nigeria | 2002–3 | 18 | 850 | | | Behague et al. [44] | Brazil | 1993 | 31.2 | 5403 | | | Chigbu et al [42] | Nigeria | 2003–06 | 16.3 | 2983 | | | Saunders and Makutu [45] | Fiji | 1986–96 | 14 | 1914 | | | | |
No patterns appear in the use of induction and augmentation in these countries in sub-Saharan Africa, Southeast Asia, and Latin America. Augmentation rates tend to be higher than induction rates, although not the case in El Salvador, Indonesia or Tanzania. Overall, rates of induction vary from 0.5% in Ethiopia to 26% in Indonesia. Rates of augmentation (without induction) vary from 9% in Tanzania to 38% in Benin. With the exception of Ethiopia and Tanzania, 40%–50% of these facility-based deliveries were either induced or augmented. Table 2 shows induction rates from low-income country hospitals identified via the literature review. Induction rates cited from 2 recent studies in Nigeria show rates (between 2002 and 2006) of 16% and 18% [42], [43]. The induction rates from older studies in Fiji and Brazil documented induction rates of 14% (1986–1996) and 31% (1993), respectively [44], [45]. A literature review of oxytocic use in the first and second stages of labor in 10 sub-Saharan African, Caribbean, and Asian countries in the 1990s shows great variation in augmentation rates, with hospital-based rates ranging from 2% in Senegal to 31% in Nepal (Table 3) [46]. There are no data on trends in induction or augmentation rates from low-income countries. | | | | Reference | Year | Country (city) | Oxytocin during 1st and/or 2nd stage of labor (%) | No. | |
|---|
| Escoffery et al. 1994 | 1986–1987 | Jamaica: | | Total n =10,732⁎ | | | Parish A | 14.9 | | | Parish B | 11.4 | | | Parish B2 | 10.8 | | | Parish C | 5.6 | | | Dujardin et al. 1995 [50] | 1990–1991 | Benin: | | | | | Abomey | 16.1 | 496 | | | Porto Novo | 24.2 | 819 | | | Congo: | | | | | Loubomo | 5.7 | 455 | | | Senegal: | | | | | Pikine | 10.9 | 1021 | | | Bouvier-Colle et al. 1998 | 1994–1996 | Ivory Coast: | | Not available | | | Abidjan | 13.4 | | | Mali: | | | | Bamako | 26.1 | | | Niger: | | | | Niamey | 5.7 | | | Mauritania: | | | | Nouakchott | 13.0 | | | Burkina Faso: | | | | Ouagadougou | 10.5 | | | Senegal: | | | | St. Louis | 32.9 | | | Kaolack | 2.5 | | | Ellis et al. 2000 | 1995–1996 | Nepal: Kathmandu | 31.1 | 766⁎⁎ | | | | |
We found few citations with rates of elective induction in low-income countries (Table 4). Two recent studies from Nigeria show elective induction rates of 7% and 13% [42], [47]. An older reference from Fiji reported a 30% rate of elective inductions between 1986 and 1996 [45]. | | | | Author | Date of data collection | Country | Rate (%) | No. of inductions | |
|---|
| Oboro et al. [47] | 2001–2005 | Nigeria | 13.7 | 197 | | | Saunders and Makutu [45] | 1986–1996 | Fiji | 30.0 | 258 | | | Chigbu et al. [42] | 2003–2006 | Nigeria | 7.4 | 487 | | | | |
4.2. Home-based use of uterotonics for induction/augmentation We found no data on rates and outcomes of uterotonic use for induction and augmentation in home-based births attended by professionally trained practitioners. But oxytocin use before birth has been documented in home-based deliveries that are attended by a provider who is not medically trained. For example, interviews with 527 women who delivered at home in rural India found 22% of women reporting an injection of oxytocin during labor [48]. This study also interviewed traditional birth attendants (TBAs) and found several who stated that they would recommend the injection to women to hasten labor. A hospital-based study in the Sudan, found that in 9 of 86 cases of uterine rupture, oxytocin had been given at home [49]. In the highlands of Guatemala, 62% of births attended by TBAs had an injection of oxytocin prior to delivery regardless of the length of labor [32]. Additional references are likely to be available in the anthropological literature, however this review was restricted to medical databases. 4.3. Maternal and perinatal outcomes associated with induction in low-income countries We found only 3 studies from low-income countries that assessed the risk of adverse maternal or perinatal outcomes associated with induction and augmentation. A prospective, multicenter study in 2 hospitals in Benin (555 and 834 deliveries), 1 in Congo (457 deliveries), and 1 in Senegal (1048 deliveries) calculated the risk of stillbirth and neonatal resuscitation associated with the use of oxytocin relative to no use of oxytocin during normal labors [50]. When pooling results across all study sites and controlling for important confounders there was a relative risk of 1.9 (1.1–3.4) for stillbirth. The adjusted relative risks for neonatal resuscitation in the 4 individual study sites ranged from 1.9 to 5.6, and all were statistically significant. In a retrospective case-control study in a rural municipality in Guatemala in which cases were stillbirths or deaths within the first 24 hours of life among home-based births (n=29) in 1986-87 and controls were subsequent births to the same mothers (n=61) [32], intramuscular oxytocin use among intrapartum deaths (stillbirths and death within the first 24 hours) among cases was 83% compared with 54% among controls (P<0.01). A cohort study of 55 stillbirths and 2316 live births in a teaching hospital in India found an unadjusted relative risk of asphyxia among liveborns of 1.9 (1.1–3.4) associated with oxytocin induction; however, after adjustment for confounders no significant difference was found [51]. A group of studies reviewing the etiology of ruptured uterus found induction or augmentation associated with 2%–44% of the cases of ruptured uterus (Table 5) [8], [34], [49], [52], [53], [54]. A study in Bahrain found an odds ratio of ruptured uterus of 2.7 if excessive oxytocin is used or if oxytocin is used with a previous cesarean delivery [53]. A study of uterine rupture in Sudan found home-based use of oxytocin as the cause of 7.0% of uterine rupture cases [49]. | | | | Author | Date of data collection | Country | % of uterine ruptures associated with induction | No. of uterine ruptures | |
|---|
| Aboyeji et al. [52] | 1992–1999 | Nigeria | 39 | 100 | | | Ahmed [49] | 1992–1997 | Sudan | 10.5 | 86 | | | Al-Jufairi [53] | 1990–1999 | Bahrain | >50 | 45 | | | Chuni [34] | 1999–2004 | Nepal | 44 | 126 | | | Ezechi [54] | 1991–2000 | Nigeria | 41 | 61 | | | Konje et al. [8] | 1975–1986 | Nigeria | 4.9 | 227 | | | | |
Three studies, 2 from sub-Saharan Africa and 1 from India, calculated rates of various neonatal outcomes associated with induction using misoprostol and oxytocin [33], [35], [43]. All 3 studies documented rates of NICU admission. Two of these studies showed lower rates of NICU admission among misoprostol use relative to oxytocin use, although neither was statistically significant [33], [43]. The third study found no significant differences between the two (Table 6) [35]. Two studies documented meconium staining; both found higher rates with misoprostol use than with oxytocin use [33], [35], although the result for only one study was statistically significant [33]. The Tanzanian study documented a significantly lower rate of newborns with 5-minute Apgar scores less than 7 with misoprostol use relative to oxytocin use [33]. The study from India found no significant differences between rates of asphyxia for misoprostol and oxytocin use. Based on only 3 studies, neonatal outcomes for induction with misoprostol and oxytocin are similar; and although rates of meconium staining may be higher with misoprostol, this is not associated with increased rates of NICU admission, asphyxia or low Apgar scores at 5 minutes. Regarding maternal outcomes, misoprostol for labor induction significantly shortened the time between induction and delivery relative to oxytocin with no increased risks to the mother [26]. | | | | Study | Date of data collection | Country | Mecon-ium staining | Asphyxia | NICU admission | Apgar score <7 at 5 min | No. (total number in study) | |
|---|
| Kidanto et al. [33] | 2004 | Tanzania | | | | | | | | Misoprostol | 7.0 | | 23.9 | 2.8 | 142 | | | Oxytocin | 1.4† | | 45.1 (sig unclear) | 5.6† | | | Loto et al. [43] | 2002–2003 | Nigeria | | | | | | | | Misoprostol | 5.9 | 152 | | | Oxytocin | 6.8 (sig unclear) | | | Nigam et al. [35] | 2004 | India | | | | | | | | Misoprostol | 5.6 | 0 | 0 | 70 | | | Oxytocin | 0 (NS) | 0 (NS) | 0 (NS) | | | | |
4.4. Use of nonpharmacological methods of labor induction Because of concern regarding use of uterotonics in peripheral health centers without access to cesarean delivery, and the fact that they are simple to use, low risk, and low cost, we included Cochrane reviews addressing nonpharmacological methods of labor induction such as mechanical dilation of the cervix with Foley catheter or laminaria, extra-amniotic infusion, sweeping of the membranes, and artificial rupture of membranes [55], [56], [57]. Furthermore, these nonpharmacological methods are suggested in international obstetric practice guidelines as potential means of avoiding induction for a post-dates pregnancy. Cochrane meta-analyses conclude that, with the exception of extra-amniotic infusion, the nonpharmacological methods specifically cited above are not, in general, associated with adverse maternal or perinatal outcomes (such as hyperstimulation of the uterus with fetal heart changes, delivery not within 24 hours, and uterine infection) and showed reduced or no difference in the risk of cesarean delivery. Sweeping of the membranes was shown to be effective at shortening the duration of pregnancy and reducing the risk of post dates. Use of this method for nonurgent indications in low-income country settings merits further discussion. The effectiveness of all of these methods requires evaluation specifically in low resource settings. 5. Discussion and conclusions The information presented in this paper comes from 2 sources: (1) analysis of induction and augmentation rates from a 7-country study on AMTSL; and (2) a structured literature review which searched 5 electronic databases using broad search terms related to induction and augmentation. A limitation of the literature review is that the Spanish language literature was not searched. Nonetheless, the paper compiled data from 42 countries, representing all Millennium Development Goal regions, except North Africa. Not surprisingly, the data from the literature review come predominantly from district or higher level hospitals, with very little representation from the private sector or smaller health centers. The samples from 3 of 7 countries in the AMTSL study (all sub-Saharan African countries) did include health center data and suggest that induction and augmentation are being performed in those facilities. A small number of studies also document induction and augmentation outside of the health system. Although sparse data on induction and augmentation of labor from low-income countries do not permit quantification of the public health effects of elective and improper administration of these drugs, the information compiled in this review is sufficient to justify concern and responsive action to the issue of unsafe use of oxytocin and misoprostol within and outside of health facilities in low-income countries. Data from high-income countries convincingly show that induction and augmentation can be safe and effective if guidelines, resources for proper monitoring, and quick access to cesarean delivery are present. Health facility-based rates of induction and augmentation presented here are high enough to imply questionable use of these procedures even though the literature provides us with very few studies specifically documenting elective induction and augmentation. Studies suggesting that a substantial proportion of cases of ruptured uterus are caused by inappropriate use of oxytocin in a facility or at home clearly illustrate the issue, as does a multicountry study documenting increased risks of neonatal resuscitation and stillbirth due to oxytocin use during normal labor. 6. Recommendations Based on the data presented in this review, we recommend specific action in 4 areas: •Evidence based clinical practice guidelines should be developed for the appropriate use of uterotonic drugs in low resource settings, specifically citing minimum criteria for staffing and equipment. Currently, the WHO manual “Managing Complications of Pregnancy and Childbirth” outlines recommendations for manual rate estimation for induction using oxytocin infusion given the likelihood that regulatory infusion pumps will be lacking in low resource settings [6]. Additional guidelines are needed for induction with misoprostol including correct indications, precautions, dose, and route of administration. •Research is needed to document current rates of induction and augmentation and routes of administration for both oxytocin (intramuscular and nonregulated infusion) and misoprostol (manually divided tablets, appropriately packaged doses for induction and/or dissolution in water) in facility and home-based births. Rigorous investigation is needed to assess maternal and perinatal outcomes associated with elective induction versus spontaneous labor for low risk women and use of nonpharmacological methods of induction at health center and hospital levels for nonurgent and elective induction. •Community and facility-based programs are needed to ensure awareness of the potential adverse effects of inappropriate use of oxytocin and misoprostol on women and babies. Such programs may require guidelines using a variety of different formats and means of dissemination; for example, materials addressing the dangers associated with home-based use of uterotonics for induction and augmentation which could be used during prenatal care or with TBAs or with community groups directly, and materials for health care providers, government pharmacists, and private drug sellers regarding the various available uterotonics, their dosages, and appropriate uses. •Policy makers should incorporate AMTSL and its adjuncts into policies for training, job descriptions, pharmaceutical policy etc. Options for addressing postpartum hemorrhage, the leading cause of maternal death in many low-income countries, are currently among the most promising within safe motherhood. They include the possibility of widespread use of misoprostol for home-based deliveries; the increasing production and distribution of certified and appropriate packaging of misoprostol; development and application of a time/temperature monitor for use on oxytocin ampoules; Uniject (Becton Dickinson, USA) for ease of oxytocin administration; and an ongoing WHO study to identify the most effective elements of AMTSL. However, progress in addressing postpartum hemorrhage should not result in increased harm due to the availability of life-saving uterotonic drugs. We encourage researchers to rigorously investigate this issue and for program managers to incorporate appropriate use of uterotonic drugs in their efforts to address postpartum hemorrhage. Acknowledgements This study was funded by the United States Agency for International Development under contract numbers GHS-I-O2-03-00028-00. The authors also wish to acknowledge the contributions to formulating recommendations provided by an expert group on induction and augmentation which was convened at PATH, Washington DC on March 19, 2008 regarding the working paper that preceded this manuscript. References [1]. [1]Derman RJ, Kodkany BS, Goudar SS, Geller SE, Naik VA, Bellad M, et al. Oral misoprostol in preventing postpartum haemorrhage in resource-poor communities: A randomised controlled trial. Lancet. 2006;368(9543):1248–1253. Abstract | Full Text |
Full-Text PDF (95 KB)
|
CrossRef
[2]. [2]Global misoprostol registration by indication. [Venture Strategies homepage on the Internet]. 2007. Available from: http://backyard.venturestrategies.org/get_file.php. [3]. [3]Royal College of Obstetricians and Gynaecologists . Induction of labor: Evidence-based Clinical Guideline Number 9. Clinical Effectiveness Support Unit. London, UK: RCOG Press; 2001;. [4]. [4]Society of Obstetricians and Gynecologists of Canada . Induction of labour at term. Clinical Practice Guideline No. 107. SOGC; 2001;. [5]. [5]American College of Obstetricians and Gynecologists . Induction of labor. ACOG Practice Bulletin Number 10. Washington DC: ACOG; 1999;. [6]. [6]World Health Organization . Managing complications in pregnancy and childbirth: A guide for midwives and doctors. Geneva: WHO; 2003;. [7]. [7]Zheng QL, Zhang XM. Analysis of 39 cases of maternal deaths caused by incorrect use of oxytocin [in Chinese]. Zhonghua fu chan ke za zhi. 1994;29(5):276–7, 316. [8]. [8]Konje JC, Odukoya OA, Ladipo OA. Ruptured uterus in Ibadan—a twelve year review. Int J Gynecol Obstet. 1990;32(3):207–213. [9]. [9]Seyb ST, Berka RJ, Socol ML, Dooley SL. Risk of cesarean delivery with elective induction of labor at term in nulliparous women. Obstet Gynecol. 1999;94(4):600–607. MEDLINE |
CrossRef
[10]. [10]Prysak M, Castronova FC. Elective induction versus spontaneous labor: a case-control analysis of safety and efficacy. Obstet Gynecol. 1998;92(1):47–52. MEDLINE |
CrossRef
[11]. [11]Maslow AS, Sweeny AL. Elective induction of labor as a risk factor for cesarean delivery among low-risk women at term. Obstet Gynecol. 2000;95(6 p 1):917–922. MEDLINE |
CrossRef
[12]. [12]Boulvain M, Marcoux S, Bureau M, Fortier M, Fraser W. Risks of induction of labour in uncomplicated term pregnancies. Paediatr Perinat Epidemiol. 2001;15(2):131–138. MEDLINE |
CrossRef
[13]. [13]Cammu H, Martens G, Ruyssinck G, Amy J. Outcome after elective labor induction in nulliparous women: A matched cohort study. Am J Obstet Gynecol. 2002;186(2):240–244. Abstract | Full Text |
Full-Text PDF (67 KB)
|
CrossRef
[14]. [14]Johnson DP, Davis NR, Brown AJ. Risk of cesarean delivery after induction at term in nulliparous women with an unfavorable cervix. Am J Obstet Gynecol. 2003;188(6):1565;. Abstract | Full Text |
Full-Text PDF (94 KB)
|
CrossRef
[15]. [15]Glantz JC. Elective induction vs. spontaneous labor: Associations and outcomes. J Reprod Med. 2005;50(4):235–240. MEDLINE [16]. [16]Enkin M, Keirse M, Neilson J, Crowther C, Duley L, Hodnett E, et al. Effective care in pregnancy and childbirth. Oxford University Press; 2000;. [17]. [17]Cunningham GF, Leveno KL, Bloom SL, Hauth JC, Gilstrap LC, Wenstrom KD. Williams Obstetrics. 22nd Edition. New York: McGraw-Hill; 2005;. [18]. [18]Hannah ME, Hannah WJ, Hellmann J, Hewson S, Milner R, Willan A. Induction of labor as compared with serial antenatal monitoring in post-term pregnancy: A randomized controlled trial. NEJM. 1992;326(24):1587–1592. MEDLINE [19]. [19]Heimstad R, Romundstad PR, Hyett J, Mattsson L, Salvesen KA. Women's experiences and attitudes towards expectant management and induction of labor for post-term pregnancy. Acta Obstet Gynecol Scand. 2007;86(8):950–956.
CrossRef
[20]. [20]Heimstad R, Skogvoll E, Mattsson LA, Johansen OJ, Eik-Nes SH, Salvesen KA. Induction of labor or serial antenatal fetal monitoring in postterm pregnancy: A randomized controlled trial. Obstet Gynecol. 2007;109(3):609–617. MEDLINE [21]. [21]Gulmezoglu AM, Crowther CA, Middleton P. Induction of labour for improving birth outcomes for women at or beyond term. Cochrane Database Syst Rev. 2006;(4):CD004945. [22]. [22]Bodner-Adler B, Bodner K, Pateisky N, Kimberger O, Chalubinski K, Mayerhofer K, et al. Influence of labor induction on obstetric outcomes in patients with prolonged pregnancy: A comparison between elective labor induction and spontaneous onset of labor beyond term. Wien Klin Wochenschr. 2005;117(7-8):287–292. MEDLINE |
CrossRef
[23]. [23]International Confederation of Midwives and International Federation of Gynecology and Obstetrics . Joint statement: Management of the third stage of labour to prevent postpartum haemorrhage. London: FIGO; 2003;. [24]. [24]Alfirevic Z, Blum J, Walraven G, Weeks A, Winikoff B. Prevention of postpartum hemorrhage with misoprostol. Int J Gynecol Obstet. 2007;99(Suppl 2):S198–201. [25]. [25]Gulmezoglu AM, Forna F, Villar J, Hofmeyr GJ. Prostaglandins for preventing postpartum haemorrhage. Cochrane Database Syst Rev. 2007;(3):CD000494. [26]. [26]Nakintu N. A comparative study of vaginal misoprostol and intravenous oxytocin for induction of labour in women with intra uterine fetal death in Mulago Hospital, Uganda. Afr Health Sci. 2001;1(2):55–59. MEDLINE [27]. [27]Ebeigbe PN, Enabudoso E, Ande AB. Ruptured uterus in a Nigerian community: A study of socio-demographic and obstetric risk factors. Acta Obstet Gynecol Scand. 2005;84(12):1172–1174. MEDLINE |
CrossRef
[28]. [28]Ekele BA, Nnadi DC, Gana MA, Shehu CE, Ahmed Y. Misoprostol use for cervical ripening and induction of labor in a Nigerian teaching hospital. Niger J Clin Pract. 2007;10(3):234–237. [29]. [29]Beebe LA, Rayburn WF, Beaty CM, Eberly KL, Stanley JR, Rayburn LA. Indications for labor induction: differences between university and community hospitals. J Reprod Med. 2000;45(6):469–475. MEDLINE [30]. [30]Hofmeyr GJ, Gülmezoglu AM. Vaginal misoprostol for cervical ripening and induction of labour. Cochrane Database Syst Rev. 2003;(1):CD000941. [31]. [31]Hofmeyr GJ, Gulmezoglu AM, Alfirevic Z. Misoprostol for induction of labour: A systematic review. Br J Obstet Gynaecol. 1999 Aug;106(8):798–803. MEDLINE [32]. [32]Bartlett A, Paz De Bocaletti ME. Intrapartum and neonatal mortality in a traditional indigenous community in rural Guatemala. Act Paediatr Scand. 1991;80(3):288–296. [33]. [33]Kidanto HL, Kaguta MM, van Roosmalen J. Induction of labor with misoprostol or oxytocin in Tanzania. Int J Gynecol Obstet. 2007;96(1):30–31. [34]. [34]Chuni N. Analysis of uterine rupture in a tertiary center in eastern Nepal: Lessons for obstetric care. J Obstet Gynaecol Res. 2006;32(6):574–579. MEDLINE |
CrossRef
[35]. [35]Nigam A, Singh VK, Dubay P, Pandey K, Bhagoliwal A, Prakash A. Misoprostol vs. oxytocin for induction of labor at term. Int J Gynecol Obstet. 2004;86(3):398–400. [36]. [36]Weeks A, Alfirevic Z, Faúndes A, Hofmeyr GJ, Safar P, Wing D. Misoprostol for induction of labor with a live fetus. Int J Gynecol Obstet. 2007;99(Suppl 2):S194–197. [37]. [37]Hofmeyr GJ, Alfirevic Z, Matonhodze B, Brocklehurst P, Campbell E, Nikodem VC. Titrated oral misoprostol solution for induction of labour: A multi-centre, randomized trial. BJOG. 2001;108(9):952–959. MEDLINE |
CrossRef
[38]. [38]Weeks A, Alfirevic Z. Oral misoprostol administration for labor induction. Clin Obstet Gynecol. 2006;49(3):658–671. MEDLINE |
CrossRef
[39]. [39]Alfirevic Z, Weeks A. Oral misoprostol for induction of labour. Cochrane Database Syst Rev. 2006;(2):CD001338. [40]. [40]Lovold A, Stanton C, Armbruster D. Use of oxytocin and misoprostol for induction or augmentation of labor in low-resource settings. Washington, DC: PATH; 2008;. [41]. [41]Stanton C, Armbruster D, Knight R, Ariawan I, Gbangbade S, Getachew A, et al. Lost opportunities in the prevention of postpartum hemorrhage; use of active management of the third stage of labor in seven developing countries [In press]. [42]. [42]Chigbu C, Ezeome II, Okenzie AO, Oyefara B. Induction of labor on request in a resource-poor setting. Int J Gynecol Obstet. 2007;98(3):208–211. [43]. [43]Loto OM, Fadahunsi AA, Kolade CO. Safety and efficacy of misoprostol for induction of labour in a semi-urban hospital setting. J Obstet Gynaecol. 2004;24(6):638–640. MEDLINE |
CrossRef
[44]. [44]Behague DP, Victora CG, Barros FC. Consumer demand for caesarean sections in Brazil: Informed decision making, patient choice, or social inequality? A population based birth cohort study linking ethnographic and epidemiological methods. BMJ. 2002;324(7343):942–945. [45]. [45]Saunders DL, Makutu SL. Cesarean section deliveries in Fiji, 1986 to 1996. Pac Health Dialog. 2001;8(1):71–77. MEDLINE [46]. [46]Buekens P. Overmedicalization of maternal care in developing countries. In: Studies in Health Service Organizations and Policy 17, Safe Motherhood Strategies: a Review of the Evidence. Antwerp, Belgium: ITGT Press; 2001;. [47]. [47]Oboro VO, Isawumi AI, Akinola SE, Komolafe JO, Tijani AM, Adesina AO. Factors predicting failure of labour induction. Niger Postgrad Med J. 2007;14(2):137–139. MEDLINE [48]. [48]Sharan M, Strobino D, Ahmed S. Intrapartum oxytocin use for labor acceleration in rural India. Int J Gynecol Obstet. 2005;90(3):251–257. [49]. [49]Ahmed SM, Daffalla SE. Incidence of uterine rupture in a teaching hospital, Sudan. Saudi Med J. 2001;22(9):757–761. MEDLINE [50]. [50]Dujardin B, Boutsen M, De Schampheleire I, Kulker R, Manshande JP, Bailey J, et al. Oxytocics in developing countries. Int J Gynecol Obstet. 1995;50(3):243–251. [51]. [51]Chandra S, Ramji S, Thirupuram S. Perinatal asphyxia: Multivariate analysis of risk factors in hospital births. Indian Pediatr. 1997;34(3):206–212. MEDLINE [52]. [52]Aboyeji AP, Ijaiya M-DA, Yahaya UR. Ruptured uterus: A study of 100 consecutive cases in Ilorin, Nigeria. J Obstet Gynaecol Res. 2001;27(6):341–348. MEDLINE [53]. [53]Al-Jufairi A, Sandhu A, Al-Durazi K. Risk factors of uterine rupture. Saudi Med J. 2001;22(8):702–704. MEDLINE [54]. [54]Ezechi O, Mabayoje P, Obiesie L. Ruptured uterus in south western Nigeria: A reappraisal. Singapore Med J. 2004;45(3):113–116. MEDLINE [55]. [55]Boulvain M, Kelly A, Lohse C, Stan C, Irion O. Mechanical methods for induction of labour. Cochrane Database Syst Rev. 2001;(4):CD001233. [56]. [56]Boulvain M, Stan C, Irion O. Membrane sweeping for induction of labour. Cochrane Database Syst Rev. 2005;(1):CD000451. [57]. [57]Smyth RM, Alldred SK, Markham C. Amniotomy for shortening spontaneous labour. Cochrane Database Syst Rev. 2007;(4):CD006167. a Owen Sound, Ontario, Canada b The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA c PATH, Washington DC, USA  Corresponding author. 369 2nd Avenue East, Owen Sound, Ontario, Canada N4K 2M6. Tel.: +1 519 370 0462.
PII: S0020-7292(08)00377-9 doi:10.1016/j.ijgo.2008.08.009 © 2008 International Federation of Gynecology and Obstetrics. Published by Elsevier Inc. All rights reserved. | |
|
FULL TEXT