EDITORIAL COMMENT: This observational study makes the valuable point that the outcomes of labour and delivery where labour was induced for nonmedical indications, were comparable for the outcomes of spontaneous labour. As the authors point out this challenges the premise of the RACOG Obstetric Indicator which suggests that induction of labour for ‘nondefined’ indications should be kept to a minimum. This implies that labour can properly be induced for ‘social’ indications without concern for increasing the rate of birth complications. However, as the authors point out, this conclusion requires further testing in a prospective study where the state of the cervix is evaluated.
Summary: We report a review of maternal and neonatal outcomes of labour in 1,405 pregnancies managed during a 12-month period. This included all singleton pregnancies of greater than 20 weeks' gestation, excluding women antenatally assigned for Caesarean delivery. Labour was induced in 313 cases (22.3%), and records were available for review in 311 of these. We classified the indications for induction according to the Australian Council of Healthcare Standards (ACHS) / RACOG list of ‘defined’ indications in Obstetric Clinical Indicator number 1. In 165 cases (53.7%) labour was induced for defined indications. There was no significant difference in the rates of instrumental vaginal delivery, Caesarean delivery or adverse neonatal outcome (admission to neonatal nursery in the first 24 hours of life; 5 minute Apgar score of <7) between women who laboured spontaneously and those induced for ‘nondefined’ indications. However, labours induced for ‘defined’ indications had a significantly increased rate of these outcomes.