Elective induction of labor at 39 (vs 41) weeks: Caveats and considerations
“39 weeks and out” concluded Errol Norwitz, MD, PhD, during a debate at the 2016 ACOG Annual Clinical and Scientific Meeting. His co-debater Charles Lockwood, MD, agreed. Here, a look at their conclusions, and what could be important to keep in mind.
Cost implicationsElectively inducing labor in all women with low-risk pregnancies at 39 weeks is a strategy with unknown cost implications, and the cost difference between this strategy and expectant management up to 41 weeks is not known.
“We need to be sure that we understand the cost implications of these strategies, which of course would need to be balanced against the potential perinatal and maternal morbidity and fetal death,” said Dr. Lockwood.
The meaning of “elective”Dr. Norwitz also made the point postdebate that the American College of Obstetricians and Gynecologists (ACOG) does not support elective IOL prior to 39 weeks’ gestation. “The key term here is ‘elective,’" he said, "which refers to a delivery without a clear medical or obstetric indication. ACOG does support delivery prior to 39 weeks’ gestation, there just needs to be an appropriate indication.”
