A comparative study based on five hundred consecutive cases of induction of labor

Abstract

This is a report of 500 consecutive inductions of labor in 430 patients all of whom were past the thirty-eighth week of pregnancy. In 338 patients the induction was successful. In 26 patients there were two inductions and in 16 patients there were three to five inductions. Six methods were tested. Pituitrin alone was successful in 26 per cent, castor oil in 53 per cent, castor oil and quinine in 63 per cent, castor oil and pituitrin in 69 per cent, castor oil with quinine and pituitrin in 73 per cent, and bag insertions in 95 per cent. Stripping the membranes markedly increases the percentage of success in each group. After the membranes were stripped, pituitrin was successful in 36 per cent, castor oil in 77 per cent, castor oil and quinine in 81 per cent, castor oil and pituitrin in 83 per cent, and castor oil with quinine and pituitrin in 94 per cent. Primiparae respond to induction methods to the same degree as do multiparae. Stripping the membranes does not hasten the onset of labor nor shorten the duration of labor. The medicinal induction of labor raises the gross and corrected morbidity from 8.6 per cent and 5.1 per cent to 10.5 per cent and 5.8 per cent respectively. When stripping is added, the morbidities increase to 11.6 per cent and 6.4 per cent respectively. The morbidity following bag inductions in this series is 33.3 per cent and 27.7 per cent respectively. There is no effect upon fetal mortality or morbidity.