Induction and Augmentation of Labor

Certain maternal and fetal conditions require induction of labor for the safety and well-being of either the mother or baby. Similarly, once fetal maturity has been reached, elective induction of labor remains an option for delivery timing and patient request. A thorough understanding of the physiologic mechanisms of labor onset and maintenance has allowed obstetrical providers to induce labor from the quiescent state and augment spontaneous labor in the latent or prolonged state. The goal of labor induction and augmentation is the successful and expedited delivery of the neonate in a manner that is safe to both the mother and the infant. Positive maternal outcomes include a shortened admission to onset of labor time, shortened first stage of labor, successful vaginal delivery, and avoidance of intraamniotic infection or postpartum hemorrhage. Positive fetal outcomes include absence of meconium amniotic fluid staining, regular newborn nursery admission, and hospital discharge with the mother. In this review, we outline the various mechanical, chemical, and natural methods of labor induction and augmentation, including a detailed assessment of the risks and benefits of each method for both the mother and baby. This review contains 7 figures, 4 tables, and 33 references. Key Words: amniotomy, augmentation of labor, cervical ripening, induction of labor, oxytocin, membrane sweeping, nipple stimulation, prostaglandins, transcervical balloon catheter