Use of oxytocin and misoprostol for induction or ... - POPPHI

4) To summarize current rates, trends, indications and risks associated with induction and
augmentation of labor in both HRS and LRS, with an emphasis on LRS;
5) To propose specific recommendations to address issues related to the expanded
availability of uterotonic drugs in developing country health facilities based on the
information compiled in this review; and
6) To identify gaps in knowledge and needs for further research.
2. Methods
Below is a description of the different methods used to address each of the objectives in
this review.
Objectives #1 and 2: Definitions of common terms and indications for induction and
augmentation were compiled via a review of obstetrics and midwifery texts, clinical
practice guidelines and position statements from: the American College of Obstetricians
and Gynecologists (ACOG), the Society of Obstetricians and Gynecologists of Canada
(SOGC) and the Royal College of Obstetricians and Gynecologist in the United Kingdom
(RCOG). For the LRS and international perspective we considered information from the
International Federation of Gynecologists and Obstetricians (FIGO), and the International
Confederation of Midwives (ICM) as well as the World Health Organization (WHO)
guidebook for LRS “Managing complications in pregnancy and childbirth: a guidebook
for midwives and doctors”(21). All of these documents are available upon request.
Objective #3: Three efforts to compile evidence-based recommendations for methods for
induction and augmentation of labor with oxytocin or misoprostol were pursued: 1) a
review of the above-mentioned guidelines; 2) a structured review of the literature,
described in detail below and 3) a review of the studies in the Cochrane library of
systematic reviews.
Objective #4: Three methods for collecting national and sub-national rates, trends,
indications and risks associated with induction and augmentation of labor were pursued;
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