Induction of labour

The most serious outcome of cesarean delivery is maternal death. Landon and colleagues1 documented a 1 in 3000 risk of maternal death associated with non-emergency cesarean delivery. Mishanina and colleagues2 state that induction had no impact on maternal death. This unqualified statement implies that maternal deaths were reported for all 157 studies and all 31 085 study participants. Only 20 of the 157 studies included (12.7%) reported occurrences of maternal death. The authors don’t show the number of study participants upon which their conclusion about maternal death is based. However, if the number is 12.7% of 31 085 (3948), this number is too small to obtain significance.