David Lagrew, MD
One of the challenges of modern obstetrics in the United States has been the rise in elective inductions. In the case of nulliparous patients, an elective induction raises the chance of cesarean section and protracted labors. After analyzing hospital induction rates the department of Obstetrics and Gynecology at Saddleback Memorial instituted quality improvement processes of feedback and scheduling requirements to prevent elective induction of labor in nulliparous patients prior to 41 weeks gestation. The resultant effect of these changes reduced the percentage of such patients from 25.5% to 0.6% of nulliparous inductions and reduced the overall induction rate from 24.9% to 22.9%.
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