Is Cesarean section the right outcome for induction of labor trials? Impact of sample size and primary outcomes

Induction of labour (IOL) is an increasingly common obstetric intervention globally. There is a choice of mechanical or pharmacological methods for induction of labour when the cervix is unfavorable. Which approach is both effective and safe however is not clear due to how trials are designed and re...

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Bibliographic Details
Published in:Ultrasound in obstetrics & gynecology 2020-11, Vol.56 (5), p.645-646
Main Authors: Swarnamani, K., Smits, L. S., Palmer, K., Mol, B. W., Davies‐Tuck, M.
Format: Article
Language:English
Subjects:
Cesarean section
Clinical outcomes
Clinical trials
Induced labor
Research methodology
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Summary:Induction of labour (IOL) is an increasingly common obstetric intervention globally. There is a choice of mechanical or pharmacological methods for induction of labour when the cervix is unfavorable. Which approach is both effective and safe however is not clear due to how trials are designed and reported. A tradeoff between the common primary outcomes of vaginal birth or time to delivery and rare safety outcomes mean trials are underpowered to determine both. There is also a lack of reporting of the indications for the operative births (prolonged labour or fetal compromise) and their relationship to each IOL method. We recommend that future trials should be large enough to adequately assess both effectiveness and safety outcomes, and that the indications for operative birth are also reported. This article is protected by copyright. All rights reserved.
ISSN:0960-7692
1469-0705
DOI:10.1002/uog.22044