Hazards and benefits of elective induction of labor.

Labor, delivery, and newborn course were studied in 621 pregnancies in which labor was electively induced at or after 39 weeks, and in 3,851 control pregnancies in which the onset of labor was spontaneous. Induced labors were not prolonged, nor was the duration of ruptured membranes. Fetal distress and birth asphyxia were not more frequent after induction, and release of meconium occurred much less frequently (9.3% for induced labor versus 16.7% for spontaneous). There was greater use of epidural analgesia and of forceps delivery in induced labor. Among primiparous patients, cesarean delivery for "failure to progress" was performed in 14% of electively induced labors and 7% of spontaneous control labors, a difference not noted among multiparous patients who had a primary cesarean birth rate of less than 2%. Iatrogenic prematurity was not a problem; none of the 621 infants who was born after elective induction developed respiratory distress syndrome, and only one weighed less than 2,500 gm.