Programmed labour compared with expectant management: is it truly a need of new millennium?


  • Madhukar J. Shinde Department of Obstetrics and Gynecology, DPU University, Dr D. Y. Patil Medical College, Hospital and Research Centre, Pune, Maharashtra, India
  • Umesh S. Sabale Department of Obstetrics and Gynecology, DPU University, Dr D. Y. Patil Medical College, Hospital and Research Centre, Pune, Maharashtra, India
  • Savita S. Mehendale Department of Obstetrics and Gynecology, University, Bharat Vidyapeeth Medical College, Hospital and Research Centre, Pune, Maharashtra, India



Expectant management, Programmed labour, Prostaglandins


Background: The mechanism triggering the initiation of human parturition is still an enigma. At term a series of complex physiological, biochemical and physical processes cascade resulting in delivery of the fetus. This study deals exclusively with comparison of normal labour, induction of labour with prostaglandin, and with augmentation by intracervical insertion of PGE2 tablets, amniotomy and smooth muscle relaxant. Advantages and disadvantages of each of the above methods are compared with expectant management of labour. Aim of this study was to compare pros and cons of programmed labour that to with expectant management.

Methods: Study was conducted in Department of Obstetrics and Gynaecology, Bharati Hospital and Research Centre, Pune. It was a prospective randomized clinical trial. 100 pregnant full term women, were selected for each group. At 0 hour primiprost tablet is inserted into the vagina close to the cervix. Frequency of repetition of tablet will be at three hours interval. Patient will be monitored.

Results: The youngest one being of age 17 years and the eldest being of age 29 years. In this, we observed those primi and 2nd gravida patients 2-2 tablets each in latent phase and 1-1 tablets in active phase. The induction delivery Interval in primigravida was observed to be of average of 9 hours. While in II Gravida was 6.5 hours, in III Gravida 5.5 hours and in IV Gravida 4 hours.

Conclusions: It has been proved beyond doubt that by programmed labour, the patient definitely can get the benefit of decrease in duration of labour.


Kamel RM. The onset of human parturition. Arch Gynecol Obstet. 2010;281(6):975-82.

O’Brien WF. The role of prostaglandins in labour and delivery. Clin Perinatol. 1995;22(4):973-84.

Boulvain M, Kelly AJ, Irion O. Intracervical prostaglandins for induction of labour. Cochrane Database Syst Rev. 2008:1.

Bakker JJ, van der Goes BY, Pel M, Mol BW, van der Post JA. Morning versus evening induction of labour for improving outcomes. Cochrane Database Syst Rev. 2013:2.

Alfirevic Z, Keeney E, Dowswell T, Welton NJ, Medley N, Dias S, et al. Which method is best for the induction of labour? A systematic review, network meta-analysis and cost-effectiveness analysis. Health Technol Asses. 2016.

Mularz A, Gutkin R. Maternal age and successful induction of labor in the United States, 2006-2010. Obstet Gynecol. 2014;123:73S.

Grobman WA, Rice MM, Reddy UM, Tita AT, Silver RM, Mallett G, et al. Labor induction versus expectant management in low-risk nulliparous women. New Eng J Med. 2018;379(6):513-23.

Fraser WD, Turcot L, Krauss I, Brisson‐Carrol G. Amniotomy for shortening spontaneous labour. Birth. 2001;28(2):139.

Induction of labour with prostaglandin E2; a prospective audit.Gudex G1.N Z Med J. 1993 Mar 10;106(951):78-80.

Amano K, Saito K, Shoda T, Tani A, Yoshihara H, Nishijima M. Elective induction of labor at 39 weeks of gestation: a prospective randomized trial. J Obstet Gynaecol Res. 1999;25(1):33-7.

Hannah ME, Huh C, Hewson SA, Hannah WJ. Postterm pregnancy: putting the merits of a policy of induction of labor into perspective. Birth. 1996;23(1):13-9.

Thorsell M, Lyrenäs S, Andolf E, Kaijser M. Starting time for induction of labor and the risk for night-time delivery. Sex Reprod Healthc. 2011;2(3):113-7.

Cochrane Database of Systematic Reviews Induction of labour for improving birth outcomes for women at or beyond term Cochrane Systematic Review - Intervention, 2018. Available at:






Original Research Articles