Corticosteroids for cervical ripening and induction of labour

The role of corticosteroids in the induction of labour is uncertain.

Sometimes it is considered beneficial to bring labour on artificially. There are many different methods used and one is to give corticosteroids to ripen the cervix and induce labour. The review included only one small trial and found that there was no evidence of the effectiveness of corticosteroids on either induction of labour or cervical ripening.

Authors' conclusions: 

The effectiveness of corticosteroids for induction of labour is uncertain. This method of induction of labour is not commonly used and so further research in this area is probably unwarranted.

[Note: The seven citations in the awaiting classification section of the review may alter the conclusions of the review once assessed.]

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Background: 

The role of corticosteroids in the process of labour is not well understood. Animal studies have shown the importance of cortisol secretion by the fetal adrenal gland in initiating labour in sheep. Infusion of glucocorticosteroids into the fetus has also shown to induce premature labour in sheep. Given these studies it has been postulated that corticosteroids will promote the induction of labour in women. This is one of a series of reviews of methods of cervical ripening and labour induction using standardised methodology.

Objectives: 

To determine the effects of corticosteroids for third trimester cervical ripening or induction of labour in comparison with other methods of cervical priming or induction of labour.

Search strategy: 

We searched the Cochrane Pregnancy and Childbirth Group Trials Register (December 2005) and bibliographies of relevant papers. We updated this search on 16 July 2009 and added the results to the awaiting classification section.

Selection criteria: 

Clinical trials of corticosteroids for third trimester cervical ripening or labour induction.

Data collection and analysis: 

A strategy was developed to deal with the large volume and complexity of trial data relating to labour induction. This involved a two-stage method of data extraction. We assessed trial quality. We contacted study authors for additional information. We collected adverse effects information from the trials.

Main results: 

Only one small trial (66 women) was included. The primary outcome vaginal birth within 24 hours was not reported. No benefit of intramuscular administration of corticosteroids with
intravenous oxytocin was found when compared with oxytocin alone. However, given the small size of this trial this result should be interpreted cautiously.

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