**3.2 Fetal indications**


In addition to the abovementioned maternal and fetal indications, labor induction can be done for allowing the essential treatment to be commenced, such as for cervical cancer, relieving emotional distress after intrauterine death in previous pregnancy, or alleviating anxiety about the baby's well-being [10]. Likewise, although currently available guidelines do not recommend it, induction of labor is being used more and more at the request of pregnant women to shorten the duration of pregnancy or to time the birth of the baby according to the convenience of the mother and/or healthcare workers [3, 5, 11, 12].

In general, the reason for induction varies from area to area. According to a study done in Latin America, premature rupture of membranes was the single most frequent medical indication accounting for 25.3% of the indications, while post-term pregnancy was the second most common. Another systematic study done in Africa shows that PROM was the most common (27.3%) reason for artificial initiation of labor [2]. In another study done in Saudi Arabia, the most common indication for IOL was postterm pregnancy accounting for (31%) cases followed by gestational and preexisting diabetes mellitus, together 23.2%, while PROM was the third most common indication accounting for 15% [12].

In conclusion, induction of labor is recommended when the risk of continuation of pregnancy either to the mother or to the fetus is more than that of continuing the pregnancy. However, sometimes induction for maternal interest may compel ignoring the fetus.
