Induction Of Labor In Women Research Articles

Artificial rupture of membranes as a mode for induction of labor in women with a previous cesarean section- a retrospective cohort study

BackgroundInduction of labor in women with a previous cesarean section (CS) is associated with increased rates of uterine rupture and failed attempt for vaginal delivery. Prostaglandins use is contraindicated in this population, limiting available options for cervical ripening.ObjectiveTo evaluate the efficacy and safety of artificial rupture of membranes (AROM) as a mode of Induction of labor (IOL) in women with a previous cesarean section.MethodsA retrospective cohort study conducted in a single tertiary care center between January 2015 and October 2020. Women with one previous cesarean section and a current singleton term pregnancy requiring IOL, with an unfavorable cervix, were included. The primary outcome was a successful vaginal delivery (VBAC); secondary outcomes were rates of chorioamnionitis, uterine rupture and low Apgar score (< 7).ResultsOf the 665 women who met the inclusion criteria, 492 (74%) did not receive subsequent oxytocin and 173 (26%) did. There were significant differences in the baseline characteristics between these two groups, including maternal age, cervical dilation at presentation, parity, and a history of a previous VBAC. Among women who were induced solely by AROM the rate of a successful TOLAC was higher (81.3% vs 73.9%), total time of IOL was shorter (mean 8.7 h vs.16.1 h) and the risk of chorioamnionitis was lower (7.3% vs 18.4%). When subdividing the women who received oxytocin into early (< 12 h after AROM) vs late (> 12 h after AROM) administration, there were no significant changes in the rates of successful VBAC or of chorioamnionitis.ConclusionAROM as a single mode of IOL in women with a previous CS is a safe and efficient practice with high rates of successful VBAC. When spontaneous labor does not develop, there is no advantage to delay the administration of oxytocin.

Induction of labour with misoprostol in premature rupture of membranes after 34 weeks: Which route is better and at what dose a randomized control trial in a tertiary care hospital

Background: The idea of this study was to evaluate the efficacy and safety of different routes of administration of misoprostol - 50µg oral, 25µg vaginal and 50µg sublingual for induction of labour in women with premature rupture of membranes after 34 weeks of gestation.Design: Randomized controlled trial.Sample: A total of 252 women with premature rupture of membranes after 34 weeks of gestation with indications of induction of labour.Methods: Study was conducted from 01/02/2022 to 31/11/2022, Women admitted to ward with premature rupture of membranes (PROM) after 34 weeks of gestation and requiring induction of labour were randomized into three groups. A total of 252 women participated in the study and were assigned to three groups to receive either 50µg oral misoprostol (n=82) or 25µg vaginal misoprostol (n=85) or 50µg sublingual misoprostol (n=85). The doses were repeated 4 hourly till active labour was established or up to a maximum of 4 doses.Major outcomes: 1.Induction to active labour 2.induction to delivery intervals 3.Delivery modes and 4.fetal outcomes were noted.Results: The mean induction to active labour interval was not significantly different in the three groups (oral vs vaginal vs sublingual- 7.54±4.8 vs 7.77±4.1 h vs 7.68±5.1 h; p=0.92). There was no significant difference in the induction to delivery time interval among the three misoprostol groups (oral vs vaginal vs sublingual – 10.7± 5.5 h vs 11.2±5.0 h vs 11.2±6.4 h; p= 0.88). Spontaneous vaginal delivery rate, instrumental delivery rate and lower segment caesarean section rates were comparable among the three groups. The spontaneous vaginal delivery is more in vaginal group and least in the sublingual group. The oral group is almost equal to the sublingual group in spontaneous delivery. The number of neonates with APGAR score <7 (low APGAR) at 1 minute of birth was highest in sublingual group and lowest in vaginal group which was statistically significant (oral vs vaginal vs sublingual, 16.8% vs 9.4% vs 20%; p= 0. 04). APGAR score <7 at 5 minutes was not significantly different among the three groups (oral vs vaginal vs sublingual, 6.02% vs 3.5% vs 7.05%; p=0.2). This implies that the need for immediate resuscitation was more in the sublingual group. Neonatal intensive care admission was least in the vaginal group although the difference was not statistically significant.Conclusion: 50µg oral misoprostol, 25µg vaginal misoprostol or 50µg sublingual misoprostol for induction of labour after 34 weeks of gestation have equal efficacy for induction of labour in women with spontaneous vaginal delivery is highest in vaginal route. The spontaneous vaginal delivery is more in vaginal route. The sublingual route having slightly higher incidence of low APGAR scores at one minute for the neonate.

Induction of labour for predicted macrosomia: study protocol for the ‘Big Baby’ randomised controlled trial

IntroductionLarge-for-gestational age (LGA) fetuses have an increased risk of shoulder dystocia. This can lead to adverse neonatal outcomes and death. Early induction of labour in women with a fetus suspected...

Establishing the Optimal Time for Induction of Labor in Women with Diet-Controlled Gestational Diabetes Mellitus: A Single-Center Observational Study.

To determine the optimal week for labor induction in women with diet-controlled gestational diabetes mellitus by comparing differences in perinatal and neonatal outcomes of labor induction to expectant management at different gestational weeks. Methods: This was a retrospective analysis of a prospectively recruited cohort of 797 singleton pregnancies complicated by diet-controlled gestational diabetes mellitus that were diagnosed, treated, and delivered after 37 weeks in a tertiary, university-affiliated perinatal center between January 2016 and December 2021. Results: The incidence of neonatal complications was highest when delivery occurred at 37 weeks, whereas fetal macrosomia occurred mostly at 41 weeks (20.7%); the frequency of large for gestational age infants did not differ between the groups. Conversely, the best neonatal outcomes were observed at 40 weeks due to the lowest number of neonates requiring phototherapy for neonatal jaundice (1.7%) and the smallest proportion of neonates experiencing composite adverse neonatal outcomes defined as neonatal hypoglycemia, phototherapy, clavicle fracture, or umbilical artery pH &lt; 7.15 (10.4%). Compared with expectant management, the risk for neonatal hypoglycemia was increased for induction at 39 weeks (adjusted odds ratio 12.29, 95% confidence interval 1.35-111.75, p = 0.026) and that for fetal macrosomia was decreased for induction at 40 weeks (adjusted odds ratio 0.11, 95% confidence interval 0.01-0.92, p = 0.041), after adjusting for maternal pre-pregnancy body mass index, nulliparity, and mean pregnancy A1c. Conclusions: The lowest rate of neonatal complications was observed at 40 weeks. Labor induction at 40 weeks prevented fetal macrosomia.

Establishing the Optimal Time for Induction of Labor in Women with Diet-Controlled Gestational Diabetes Mellitus: A Single-Center Observational Study

Establishing the Optimal Time for Induction of Labor in Women with Diet-Controlled Gestational Diabetes Mellitus: A Single-Center Observational Study

Induction of labor with unmedical methods via membrane stripping

Objective: The aims of this study is to determine the efficacy of membrane stripping for induction of labor in women in term and its role in increasing the rate of vaginal delivery. Collection of samples: Randomized clinical trial was conducted for the period one year (June 2020 –June 2021) at Tishreen University Hospital in Lattakia-Syria. The study included 148 pregnant women in term, and were divided into group (1) included 98 pregnant women who underwent membrane stripping, and group (2) included 50 pregnant women without membrane stripping. Results: The mean age was26.5±5.5 years, without significant differences between the two groups regarding gestational age, obstetric history, and status of cervix. In membrane stripping group, the rate of spontaneous labor was (81.63%), and the response was higher in women with intermediate cervix (89.4%). The rate of vaginal delivery was (85.7%), with low requirement for labor induction (5.1%). On the other hand, in pregnant women group without membrane stripping, the rate of spontaneous labor was (54%), and the response was higher in women with ripe cervix (77.3%). The rate of vaginal delivery was (58%), with high requirement for labor induction (26%). Conclusion: Our study findings suggest that membrane stripping represents a safe and effective procedure for induction of labor and reducing the rate of cesarean delivery especially in the case of intermediate cervix.

Vaginal prostaglandin E2 versus oxytocin for induction of labor in women with prelabor rupture of membranes at term

Aims: Majority of women with prelabor rupture of membranes (PROM) at term will go in to labor within 24 hours. However early delivery will reduce the maternal and fetal infection and reduce the need for antibiotics for newborn. It will also increase maternal satisfaction. Oxytocin is being used for several decades for induction of labor in PROM. Prostaglandin E2 (PGE2) has shown promising results for the same purpose. A randomized controlled trial carried out to determine the effectiveness and acceptability of vaginal prostaglandin E2 for induction of labor in women with PROM at term. Methods: A total of 162 women with singleton pregnancies at &gt;37 weeks, cephalic presentations, Bishop scores of and#60;6 were randomly allocated to receive either oxytocin or vaginal PGE2. The primary outcome measure was induction to delivery interval. Secondary outcomes were caesarean section rate, postpartum maternal fever, neonatal fever, and special care baby unit (SCBU) admissions. Results: The induction to delivery interval was not significantly different (p -0.558) in oxytocin group (630.9 + 31.1 min) as compared to PGE2 group (635.2 + 27.1 min). Incidence of postpartum maternal fever, neonatal fever, and SCBU admission were almost similar in both groups. Uncomplicated vaginal delivery rates 2022were almost same in both groups (65.3% in PG group and 62.5% in oxytocin group). Conclusion: Vaginal PGE2 appears to be as efficient as oxytocin for labor induction in term pregnancies with PROM and unfavorable cervices. However PGE2 doesn’t have additional advantages over oxytocin. As vaginal PGE2 is more expensive, it is rational to opt for oxytocin infusion to induce labor in term prelabor rupture of membranes accompanied with low Bishop’s scores.

Association between the cervical sliding sign and successful induction of labor in women with an unfavorable cervix: A prospective observational study

ObjectivesTo evaluate the role of the cervical sliding sign (CSS) in the prediction of the outcome of induction of labor (IOL). Study designTwo-center prospective observational cohort study involving a non-consecutive series of uncomplicated singleton term pregnancies, planned for IOL, with a fetus in cephalic presentation and unfavorable cervix as defined by a Bishop score ≤ 6. The Bishop score was evaluated by transvaginal digital examination and the cervical length and CSS by transvaginal ultrasound. The presence of CSS was defined as the sliding of the anterior cervical lip on the posterior one under gentle pressure of the transvaginal probe. The primary outcome of the study was successful vaginal delivery within 24 h. The secondary outcome was the induction-to-active-labor time. The interobserver agreement for the CSS was also evaluated. ResultsOver a period of 12 months, 179 women were included. The CSS was found in 86 (48.0 %) patients and was associated with an increased likelihood of vaginal delivery within 24 h (60/86 or 69.8 % vs 27/93 or 29.0 %, P < 0.001) and a shorter induction-to-active-labor time (954 ± 618 min vs 1416 ± 660 min, P < 0.001). Multivariable regression analysis showed that the CSS was an independent predictor of vaginal delivery within 24 h (aOR 5.37, 95 % CI 2.26–12.75) and shorter induction-to-active-labor time interval (HR 1.81, 95 % CI 1.19–2.74). The interobserver variability based on intraclass correlation coefficient for the CSS was excellent (ICC = 0.90). ConclusionIn women undergoing IOL with an unfavorable cervix, the CSS is associated with a higher frequency of vaginal delivery within 24 h and a shorter induction-to-active-labor time.

Deriving a prediction model for emergency cesarean delivery following induction of labor in singleton term pregnancies.

To derive a prediction model combining various clinical factors associated with increased risk of emergency cesarean section following induction of labor in women with unfavorable cervix. All women with singleton term pregnancies undergoing induction of labor and fulfilling inclusion criteria were included in this cross-sectional study after supplying consent. Women with a Bishop score of 6 or less were induced with dinoprostone gel. Multiple regression analysis was used to find the most significant independent predictive factors and these factors were used to develop the predictive model and calculator. After multiple logistic regression, risk of emergency cesarean after induction of labor was significantly associated with the following variables: height (adjusted odds ratio [aOR] 0.955, P= 0.033), nulliparity (aOR 3.987, P< 0.001), closed cervix (aOR 2.030, P= 0.030), fetal station -3 above ischial spine (aOR 2.719, P= 0.043), firm or medium cervical consistency (aOR 2.028, P= 0.004), cervical length 3cm or longer (aOR 3.090, P= 0.015), posterior cervix (aOR 2.112, P= 0.002). Use of a prediction model would help to reduce the number of emergency cesarean sections secondary to unsuccessful inductions and help in the reduction of maternal and perinatal morbidity.

Prospective randomized comparative study between Sustained release vaginal insert and intracervical gel in women with unfavourable cervix at term pregnancy

Background-Induction of Labour (artificially initiated labour) is a common obstetric practice in pregnant women throughout the world, accounting for 20% of all births. Induction of Labour should be performed only when there is a clear medical indication for it and the expected benefits overweigh its potential harms. Objectives- to compare between the two formulations of dinoprostone and study the better option among the two, in cervical ripening and labour induction in women with unfavourable cervix. Methods- It was a Prospective randomized comparative study done in total 100 consecutive term pregnant women who underwent labor induction for fetal or maternal indications were divided randomly into two groups. Group A - sustained release vaginal insert and Group B - Intracervical gel. Informed consent was taken from each patient. SPSS (Version 22.0) was used for analysis. Results- Statistically significant increase in final Bishop’s score (p=0.01) and hyperstimulation (p=0.04) was seen in Vaginal insert group as compared to Intracervical gel group, while there were no statistically significant differences in maternal outcomes, neonatal outcomes and need for oxytocin augmentation in both groups.

Efficacy and Safety Analysis of Phloroglucinol in Combination with Oxytocin for the Induction of Labor in Women with Term Premature Rupture of Membranes (PROM).

Objective The purpose of this study was to investigate the efficacy and safety of phloroglucinol in combination with oxytocin in the induction of labor in women who had experienced term premature rupture of membranes (PROM). Methods Data from 100 women who experienced PROM between December 2020 and December 2021 were retrospectively evaluated in this study. The puerperae were categorized into observation and control groups based on their uterine contraction regimens. The observation group consisted of 53 participants that had been treated with phloroglucinol in combination with oxytocin, and the control group consisted of 47 participants that had been treated with oxytocin alone. It was observed and compared in terms of the Bishop score before and after the administration of the puerpera to see which group had the best index. A study was performed after the drug was administered to examine its effects on the duration of labor (including the first, second, and third stages of labor), the mode of delivery (including natural vaginal delivery and cesarean section), the incidence of adverse pregnancy outcomes (fetal distress and neonatal asphyxia), successful labor induction, and complication rates. Results Patients in the observation group had a significantly higher Bishop score after administration than those in the control group (P < 0.05), although there was no difference between the two groups before administration. In comparison to the control group, the observation group had a significantly higher efficacy rate for drug administration (P < 0.05), as well as a significantly lower occurrence of the first stage of labor (P < 0.05), a higher rate of vaginal natural delivery and successful induction of labor (P < 0.05), and a significantly lower incidence of adverse pregnancy outcomes and complications (P < 0.05). Conclusion In conclusion, the use of phloroglucinol in combination with intravenous oxytocin in the process of promoting cervical ripening and induction of labor for women with PROM who are at term was investigated. This study could help women speed up cervical dilation, improve the cervical Bishop scores, shorten the total labour process, improve the effective rate of vaginal delivery, and be very safe, making it a good candidate for clinical promotion and application.

Induction of Labour in Women with Class III Obesity (Body Mass Index ≥40 kg/m2)—Maternal and Neonatal Outcomes

Induction of Labour in Women with Class III Obesity (Body Mass Index ≥40 kg/m2)—Maternal and Neonatal Outcomes

43 Obstetric outcomes after induction of labor in women with prior cesarean delivery

Introduction and aims of the study: An increasing number of women with a previous cesarean delivery undergo cervical ripening and/or induction of labor. Methods: We performed a population-based, retrospective cohort analysis using data from all primiparous women with prior cesarean deliveries who had their second singleton child at the authors’ Department, from November, 2013 to November, 2019 (total of 150 women). Authors then describe and compare the obstetric outcomes from induction of labor with and without prostaglandins using Fisher Exact Test, with P values <0.05 denoting statistical significance.

Is there an increased risk of cesarean section in obese women after induction of labor? A retrospective cohort study.

BackgroundObesity is increasing in Sweden and is also of huge global concern. Obesity increases the risk of complications during pregnancy and the need for the induction of labor. Induction of labor increases the number of complications during delivery, leading to women with more negative birth experience. This study investigated how maternal body mass index (BMI) during antenatal care enrollment affects labor outcomes (proportion of cesarean section at induction of labor).MethodThis was a retrospective cohort study of 3772 women with mixed parity and induction of labor at Soderhospital, Stockholm, in 2009–2010 and 2012–2013. The inclusion criteria were simplex, ≥34 gestational weeks, cephalic presentation and no previous cesarean section. The women were grouped according to BMI, and statistical analyzes were performed to compare the proportion of cesarean sections after induction of labor. The primary outcome was the proportion of cesarean section after induction of labor divided by group of maternal BMI. The secondary outcomes were postpartum hemorrhage >1000 ml, time of labor, fetal outcome data, and indication for emergency cesarean section.ResultThe induction of labor in women with a high BMI resulted in a significantly increased risk of cesarean section, with 18.4–24.1% of deliveries, depending on the BMI group. This outcome persisted after adjustment in women with BMI 25–29.9 (aOR 1.4; 95% CI; 1.1–1.7) and BMI 30–34.9 (aOR 1.5; 95% CI; 1.1–2.1). There was also a significantly higher risk for CS among primiparous women (aOR 3.6; 95% CI; 2.9–45) and if the newborn weighted ≥ four kilos (aOR 1.6; 95% CI; 1.3–2.0).ConclusionOur findings show that a higher BMI increased the risk of cesarean section after induction of labor in the groups with BMI 25–34.9. Parity seems to be the strongest risk factor for CS regardless other variables.

Dinoprostone Vaginal Insert for Induction of Labor in Women with Low-Risk Pregnancies: A Prospective Study.

Background:Induction of labor (IOL) is a technique to establish vaginal delivery when the risks for continuing the pregnancy for mother or baby are higher than the risks of delivery. It is usually performed in high-risk pregnancies, but can also be beneficial in low-risk populations, as shown in the ARRIVE trial.Objective:To evaluate the effectiveness and safety of slow-release vaginal dinoprostone (prostaglandin E2 10 mg) for labor induction in women with low-risk pregnancies.Methods:A prospective study was performed at Hanoi Obstetrics and Gynecology Hospital, Vietnam. We recruited women with low-risk pregnancies from 39 weeks + 0 days to 40 weeks + 6 days of gestation and an unfavorable cervix. Women who participated received 10 mg intravaginal slow-release dinoprostone (Propess) for induction of labor. Labor, deliveries, and post-partum management were performed according to the local protocol.Results:From September 2020 to March 2021, 102 low-risk women were eligible to participate in the study. Among these women, 67.6% had vaginal deliveries, 6.9% had postpartum bleeding, and 3.9% experienced tachysystole. All newborns were healthy, with good APGAR scores. None of the women needed respiratory support or intensive care unit admission. All other maternal or fetal complications were explored. The rate of cesarean section was 3.8 higher in nulliparous than multiparous women and 2.2 times higher in women who did not receive epidural analgesia than in those who did. The risk of cesarean section increased if the time between labor induction and active labor was greater than 12.5 hours.Conclusion:Slow-release dinoprostone insert is safe and effective for the induction of labor in low-risk pregnant women. The risk of cesarean section was elevated in nulliparous patients and those who did not receive epidural analgesia during labor. As the time from labor induction to active labor increased, the risk of cesarean section increased.

Induction of labor for women with obesity: “Weigh” more Pitocin?

Women with obesity (body mass index of 30 kg/m2) are more likely to have inductions of labor, longer labor courses, or failed inductions. Translational research suggests this may be due to different utilization of oxytocin among women with obesity. We aimed to explore the relationship between body mass index (BMI) and oxytocin utilization for women undergoing an induction of labor.

Evidence around early induction of labor in women of advanced maternal age and those using assisted reproductive technology

Worldwide, there has been a trend toward later motherhood. Concurrently, the incidence of subfertility has been on the rise, necessitating conception using assisted reproductive technologies (ARTs). These pregnancies are considered high risk due to fetal complications such as antepartum stillbirth and growth restriction and maternal complications such as increase in maternal morbidity and mortality. Early induction of labor can help to mitigate these risks. However, this has to be balanced against the iatrogenic harms of earlier delivery to both the baby, including respiratory distress and NICU stay, and the mother who might experience longer labor and other complications such as uterine hyperstimulation. Induction of labor at 39 weeks is the optimal timing for preventing antepartum stillbirth and avoiding iatrogenic harm. Delivery by elective cesarean section is not advocated as its benefits in these patients are unclear compared with the short- and long-term complications of a major abdominal surgery.

Balloon catheter vs oxytocin alone for induction of labor in women with one previous cesarean section and an unfavorable cervix: a multicenter, retrospective study.

To compare the rate of vaginal birth between double-balloon catheter and oxytocin alone for induction of labor in women with one previous cesarean section and an unfavorable cervix. A retrospective and observational study was conducted from 2013 to 2017, at the Saint-Etienne University Hospital where women received induction with a double-balloon catheter for 12h and at the Grenoble Alpes University Hospital where women received induction with a low-dose oxytocin infusion. Primary outcome was the rate of vaginal birth. Out of 1920 women eligible for attempting a vaginal birth after one previous cesarean section, 501 had a labor induction. Among women with an unfavorable cervix, 160 received a double-balloon catheter in Saint Etienne and 152 received oxytocin alone in Grenoble. The vaginal birth rate was higher in the double-balloon catheter group (61% versus 47% in the oxytocin group). An induction of labor with oxytocin alone reduced chances of vaginal birth (aOR 0.38 CI-95% [0.22-0.66]) compared to cervical ripening with double-balloon catheter. The perinatal morbidity was similar in the two groups. There was, however, 3.9% uterine rupture in the oxytocin group versus 0.6% in the double-balloon group (p = 0.11). For induction of labor in women with one previous cesarean section and with unfavorable cervix, cervical ripening with a double-balloon catheter increases the rate of vaginal birth without increased risk of uterine rupture.

Labor induction with randomized comparison of cervical, oral and intravaginal misoprostol

BackgroundThis study attempts to evaluate the safety and effectiveness of 50μgm intracervical misoprostol in comparison with intravaginal and sublingual for the induction of labor at term pregnant women.MethodsThis study is designed as a parallel clinical trial study. Three hundred and fifteen term pregnancies requiring induction of labor were treated with the maximum used misoprostol intracervical, sublingual, and vaginal doses. Participants were randomly allocated into three groups of 105. The dose was repeated every 4 h until adequate uterine contraction and Bishop Score were achieved. The duration of induction to births, time to the active phase, the rate of births, and the need for caesarean section were compared in three groups. Additionally, labor course and side effects were recorded and analyzed. Data were analyzed using SPSS software. A significance level of p < 0.05 was considered for statistical analyses.FindingsLabor was successfully induced in all cases most (63%) of which required a single dose of misoprostol. Ninety-three (93.0%, p < 0.05) cervical participants proceeded to vaginal births. This figure was also the same in the vaginal and sublingual group of 83 cases (83.0%). The other 41 cases received caesarean section with more indications of failure to progress and meconium-stained liquor. The results indicated that 278 (92.7%) births were achieved in less than 10 h. Time from start of medication to the active phase of labor and childbirth was 3.01 ± 0.86 and 6.1 ± 1.3 h in the Cervical group, 4.2 ± 0.66 and 8.4 ± 0.92 h in the sublingual group, and 5.06 ± 1.1 and 9.2 ± 1.5 h in the vaginal group respectively (p < 0.001). The Caesarean rate was lower in the cervical group than in the two other groups (p = 0.05). No significant differences were observed between the study groups in terms of Apgar score and meconium-stained amniotic fluid. Furthermore, no maternal and neonatal complications were observed.ConclusionIn addition to the sublingual and intravaginal routes of administration, intracervical misoprostol at a single dose of 50μgm appears to be an effective method for induction of labor in women with an unfavorable cervix. Like all medical interventions, a discussion of the risks, benefits, and alternatives to induction of labor with this medication in each woman should be undertaken before treatment.Trial registrationThis clinical study was approved by the Iranian Registry of Clinical Trials with IRCT ID: IRCT20190415043278N1. Registration date was on May 13, 2019 and May 27, 2019 respectively (http://www.irct.ir).

Outcomes and complications of pharmacological induction of labor in women with previous one cesarean section, in a referral center in Saudi Arabia.

Objectives:To review the outcomes, success rate, and safety of women undergoing labor induction following a cesarean section.Methods:This study is a retrospective review of all patients who had previous cesarean sections and were induced with prostaglandin (PGE2) or for various indications. This study was carried out at King Saud Medical City, Riyadh, Saudi Arabia between 2014 and 2019. Inclusion criteria were pregnant women with previous one lower segment cesarean section, singleton cephalic fetus, normal placenta, and passed 18 months or more from previous cesarean section.Results:Records of 145 women were reviewed in the study, and the success rate of induction of labor was 59.3% (95% CI: 50.8-67.4%). The rate of uterine rupture was 1.4% and maternal complication was 4.8%. The induction success rate is higher in women who had previous successful vaginal delivery than those who had no previous vaginal delivery.Conclusions:Labor induction can be considered safe in carefully selected cases owing to its good chance of success and no significant increase in maternal or fetal mortality and morbidity.