A Study on Induction of Labor in Low-risk Pregnancies at Different Period of Gestation in a Tertiary Care Center

Introduction:The optimal timing of delivery of low-risk pregnancy remains unclear.There are several meta-analyses which have studied the fetomaternal outcome of inducing labor at different period of gestation and compared it with expectant management.Objective: To determine the period of gestation where the most favorable fetomaternal outcomes are noted upon induction of labor (IOL) in uncomplicated pregnancies.Methodology: A retrospective, observational study was conducted from January 2021 to December 2023 at a tertiary care center in North India.All low-risk women with singleton pregnancy who had undergone IOL from 37 to 42 weeks of gestation were included.The primary maternal outcome was mode of delivery.Results: Of the 5,689 deliveries, 687 (12.08%) were low-risk pregnancies who were electively induced.Of these 687 women, 488 (71%) delivered vaginally and 199 (29%) had cesarean delivery.The maximum proportion of vaginal delivery was noted at 37 +0 -37 +6 weeks (77.9%), while the least proportion (60.2%) was noted at 40 +0 -40 +6 weeks.Least proportion of meconium-stained liquor and neonatal intensive care admission were also noted between 37 +0 and 37 +6 weeks.Maximum proportion of fetal distress (13.9%) and cesarean delivery (39.8%) were noted between 40 +0 and 40 +6 weeks. Conclusion:The gestational age of 40 +0 -40 +6 weeks showed the maximum proportion of cesarean deliveries and fetal distress.Hence, IOL may be offered in uncomplicated pregnancies in the early term period, i.e., before 40 weeks of gestation after explaining the pros and cons associated with the process of induction to provide quality care and maximize fetomaternal outcomes.