While prior research and analysis have evaluated methods of outpatient labor induction (also known as cervical ripening), the specific approach with the highest efficacy and safety remains uncertain. More than a quarter of all labors in the United States required induction in 2018, according to the National Center for Health Statistics, and will likely continue to rise in the future. A new study by Mount Sinai researchers, published in the American Journal of Obstetrics and Gynecology, aims to identify the most effective and safest cervical ripening strategy.
. DOI: 10.1016/j.ajog.2022.09.043
Unlike previous research that were limited to comparing outpatient vs. inpatient inductions or a one-to-one method comparison, this study is among the first to rank a variety of pharmacologic and mechanical labor induction methods used outside a, ranging from commonly used prostaglandin medications to alternative supplements and acupuncture.
The researchers found that compared with other available labor induction methods, 25 mcg of the medication misoprostol applied vaginally resulted in the shortest time from medical intervention to delivery. This approach did not increase the likelihood of cesarean delivery, need for additional ripening methods, low Apgar scores, or hyperstimulation. Among the effective methods, the team also found that taking 50 mg of mifepristone by mouth was associated with the lowest risk of cesarean delivery.
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