Induction of labour indications and timing: A systematic analysis of clinical guidelines.

Coates, D; Homer, C; Wilson, A; Deady, L; Mason, E; Foureur, M; Henry, A

Induction of labour indications and timing: A systematic analysis of clinical guidelines.

Coates, D

Homer, C

Wilson, A Deady, L Mason, E Foureur, M

Henry, A

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Publisher:: ELSEVIER
Publication Type:: Journal Article
Citation:: Women and birth : journal of the Australian College of Midwives, 2020, 33, (3), pp. 219-230
Issue Date:: 2020

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Field	Value	Language
dc.contributor.author	Coates, D https://orcid.org/0000-0002-4463-7615
dc.contributor.author	Homer, C https://orcid.org/0000-0002-7454-3011
dc.contributor.author	Wilson, A
dc.contributor.author	Deady, L
dc.contributor.author	Mason, E
dc.contributor.author	Foureur, M https://orcid.org/0000-0002-0454-0165
dc.contributor.author	Henry, A
dc.date.accessioned	2020-08-19T05:52:34Z
dc.date.available	2019-06-05
dc.date.available	2020-08-19T05:52:34Z
dc.date.issued	2020
dc.identifier.citation	Women and birth : journal of the Australian College of Midwives, 2020, 33, (3), pp. 219-230
dc.identifier.issn	1871-5192
dc.identifier.issn	1878-1799
dc.identifier.uri	http://hdl.handle.net/10453/142232
dc.description.abstract	BACKGROUND:There is widespread and some unexplained variation in induction of labour rates between hospitals. Some practice variation may stem from variability in clinical guidelines. This review aimed to identify to what extent induction of labour guidelines provide consistent recommendations in relation to reasons for, and timing of, induction of labour and ascertain whether inconsistencies can be explained by variability guideline quality. METHOD:We conducted a systematic search of national and international English-language guidelines published between 2008 and 2018. General induction of labour guidelines and condition-specific guidelines containing induction of labour recommendations were searched. Guidelines were reviewed and extracted independently by two reviewers. Guideline quality was assessed using the Appraisal of Guidelines for Research and Evaluation II Instrument. FINDINGS:Forty nine guidelines of varying quality were included. Indications where guidelines had mostly consistent advice included prolonged pregnancy (induction between 41 and 42 weeks), preterm premature rupture of membranes, and term preeclampsia (induction when preeclampsia diagnosed ≥37 weeks). Guidelines were also consistent in agreeing on decreased fetal movements and oligohydramnios as valid indications for induction, although timing recommendations were absent or inconsistent. Common indications where there was little consensus on validity and/or timing of induction included gestational diabetes, fetal macrosomia, elevated maternal body mass index, and twin pregnancy. CONCLUSION:Substantial variation in clinical practice guidelines for indications for induction exists. As guidelines rated of similar quality presented conflicting recommendations, guideline variability was not explained by guideline quality. Guideline variability may partly account for unexplained variation in induction of labour rates.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	ELSEVIER
dc.relation	Maridulu Budyari Gumal - The Sydney Partnership for Health, Education, Research and Enterprise (SPHERE)
dc.relation.ispartof	Women and birth : journal of the Australian College of Midwives
dc.relation.isbasedon	10.1016/j.wombi.2019.06.004
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	11 Medical and Health Sciences
dc.subject.classification	Obstetrics & Reproductive Medicine
dc.title	Induction of labour indications and timing: A systematic analysis of clinical guidelines.
dc.type	Journal Article
utslib.citation.volume	33
utslib.location.activity	Netherlands
utslib.for	11 Medical and Health Sciences
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Strength - CHSP - Health Services and Practice
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Midwifery
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Strength - WHO CC
utslib.copyright.status	open_access	*
pubs.consider-herdc	false
dc.date.updated	2020-08-19T05:52:07Z
pubs.issue	3
pubs.publication-status	Published
pubs.volume	33
utslib.citation.issue	3

Abstract:

BACKGROUND:There is widespread and some unexplained variation in induction of labour rates between hospitals. Some practice variation may stem from variability in clinical guidelines. This review aimed to identify to what extent induction of labour guidelines provide consistent recommendations in relation to reasons for, and timing of, induction of labour and ascertain whether inconsistencies can be explained by variability guideline quality. METHOD:We conducted a systematic search of national and international English-language guidelines published between 2008 and 2018. General induction of labour guidelines and condition-specific guidelines containing induction of labour recommendations were searched. Guidelines were reviewed and extracted independently by two reviewers. Guideline quality was assessed using the Appraisal of Guidelines for Research and Evaluation II Instrument. FINDINGS:Forty nine guidelines of varying quality were included. Indications where guidelines had mostly consistent advice included prolonged pregnancy (induction between 41 and 42 weeks), preterm premature rupture of membranes, and term preeclampsia (induction when preeclampsia diagnosed ≥37 weeks). Guidelines were also consistent in agreeing on decreased fetal movements and oligohydramnios as valid indications for induction, although timing recommendations were absent or inconsistent. Common indications where there was little consensus on validity and/or timing of induction included gestational diabetes, fetal macrosomia, elevated maternal body mass index, and twin pregnancy. CONCLUSION:Substantial variation in clinical practice guidelines for indications for induction exists. As guidelines rated of similar quality presented conflicting recommendations, guideline variability was not explained by guideline quality. Guideline variability may partly account for unexplained variation in induction of labour rates.

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http://hdl.handle.net/10453/142232