Women were less likely to develop infections, and fewer babies were admitted to neonatal intensive care units when labor was induced than when labor was allowed to begin spontaneously after a premature water break at term, according to the review by Philippa Middleton of the University of Adelaide in Australia and colleagues.
However, the researchers found no significant differences in newborn infection rates between the two groups of women. And the numbers of Caesarean section and vaginal births assisted by forceps or a vacuum device also were similar between women whose labor was induced (planned) and women whose labor was spontaneous (expectant).
The review appears in the current issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.
"Since planned and expectant management may not be very different, women need to have appropriate information to make informed choices," Middleton and colleagues conclude.
Only one of the 12 studies included in the review asked women whether they preferred induction or watchful waiting. The study found that women who had their labor induced were significantly more likely to say they were satisfied with their experience.
"It is vital to have a better understanding of women's preferences regarding whether or not they wish to be immediately induced or whether they wish to wait for spontaneous labor if their membranes have ruptured prematurely at term," Middleton said.
A pregnant woman's water breaks when the placental membrane ruptures at the start of or during labor
Contact: Philippa Middleton
Center for the Advancement of Health