Key Points

• First or second trimester ultrasound provides more accurate dating than even a 'certain' last menstrual period
• Establishing an expected date of delivery by scan dates alone (vs 7, 10 or 14 day 'rules') reduces unnecessary inductions for postdate pregnancy
• There appears to be little clinical benefit in using more than one dose of prostaglandin
• Misoprostol promises to be an effective induction agent but its introduction has to await a large RCT
• Uterine hyperstimulation is often underdiagnosed.
• Formal guidelines are needed, which should include the immediate stopping of oxytocin.
• There may be a place for tocolytics
• Reliance on technology - e.g. tocograph monitoring - should not lead to us ignoring our basic clinical skill