IOL in Obstetrics
IOL stands for Induction of Labor, which is the artificial stimulation of labor to initiate the delivery process before spontaneous labor begins. 1, 2
Definition and Clinical Context
IOL is a common obstetric intervention that uses artificial methods to stimulate the onset of labor, distinguishing it from spontaneous labor that begins naturally. 2, 3
The procedure involves various pharmacological and mechanical techniques to ripen the cervix and initiate uterine contractions when continuing pregnancy poses greater risks than delivery. 1, 4
Key Clinical Applications
IOL is used when expectant management (waiting for spontaneous labor) carries higher maternal or fetal risks than proceeding with delivery. 1
Common indications include postterm pregnancy (≥41 weeks), hypertensive disorders, prelabor rupture of membranes, and various maternal or fetal complications. 5, 2
The comparison should always be IOL versus expectant management with potential complications, not IOL versus spontaneous labor at the same gestational age, as the latter is not a choice clinicians can make. 1
Methods of Induction
Cervical ripening agents (prostaglandins, misoprostol) are used when the cervix is unfavorable (Bishop score <5). 5, 6, 4
Mechanical methods include Foley catheter placement and membrane sweeping. 2, 4
Oxytocin infusion and artificial rupture of membranes are used for labor augmentation, particularly when the cervix is favorable. 7, 2