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Induction of labor

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Sohayla Felfel

This document discusses induction of labor and augmentation of labor. Induction of labor is artificially initiating uterine contractions before their spontaneous onset, while augmentation is attempting to assist or accelerate labor that has begun normally. Common indications for induction include preeclampsia, PROM, post-term pregnancy, and fetal issues like IUFD or severe IUGR. Contraindications include severe CPD, major placenta previa, and active genital herpes. Methods of induction include cervical ripening using prostaglandins or dilators followed by oxytocin or amniotomy to induce contractions. Oxytocin administration begins at 1 mU/min and is increased every 30 minutes until effective contractions occur.

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Name: Sohayla Mahmoud Felfel ID..558 Induction of labour
Induction of labour Augmentation of labour Elective induction of labour Artificially initiating uterine contraction prior to their spontaneous onset. Attempt to assists or accelerate labour that have been already begun normally. Initiation of labour at term pregnancy without any acceptable medical or obstetric indications
INDICATIONS MATERNAL Preeclampsia, eclampsia PROM Postterm pregnancy Abruptio placenta Chorioamnionitis Medical conditions- DM,Heart ds, Renal ds,Chr. HTN etc FETAL IUFD postmaturity Fetal anomaly incompatible with life Severe IUGR Rh isoimmunisation Macrosomia
Severe degree CPD Major degree placenta previa Transverse lie or breech presentation Previous classical CS, Myomectomy Contracted pelvis Grand multipara or old primigravida Active genital herpes Hypersensitivity to the inducing agent CONTRAINDICATIONS
Failure leading to CS Uterine hyperstimulation Fetal distress,death Rupture uterus Intrauterine infection,sepsis Iatrogenic delivery of preterm infant Precipitate/dysfunctional labour Inc. risk of operative vaginal delivery Inc. risk of birth trauma Inc. risk of PPH Complications
Decision taken to induce labour Cervical status Bishop score Cervix ripes Cervix doesnt ripe Induce labour Ripe cervix then induce labour assessme nt
Induction of labor
Methods of cervical ripening natural mechanical pharmacological Walking Having sex Nipple stimulation Enema Acupressu re Hygroscopi c dilators Transcervic al catheter Stripping the membranes Prostaglandin E2: (dinoproston e) Prostaglandin E1
Induction of labor
Methods of induction labour Surgical Pharmacological Amniotomy Oxytocin prostaglandins
Oxytocin MECHANISM
Adminstration IV infusion Advantages: it is potent and easy to titrate, Has a short half-life (one to five minutes) Well tolerated.
Oxytocin infusion should be given in the smallest possible volume, commencing at a rate of 1 mU/min Usually start by 5 units in 500mls of normal saline or Ringers solution [10 mU/ml] Increase infusion rate (by doubling drops / min) at intervals of 30 min, until there are 3-5 good contractions every 10 min each lasting 45-60 sec. [1 ml=15-drops] If 60 drop/min rate is reached with no efficient contractions replace the infusion with 10 units oxytocin in 500 mls Total dose of oxytocin should not exceed 5 units Oxytocin Regimen:
Induction of labor

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Induction of labor

  • 1. Name: Sohayla Mahmoud Felfel ID..558 Induction of labour
  • 2. Induction of labour Augmentation of labour Elective induction of labour Artificially initiating uterine contraction prior to their spontaneous onset. Attempt to assists or accelerate labour that have been already begun normally. Initiation of labour at term pregnancy without any acceptable medical or obstetric indications
  • 3. INDICATIONS MATERNAL Preeclampsia, eclampsia PROM Postterm pregnancy Abruptio placenta Chorioamnionitis Medical conditions- DM,Heart ds, Renal ds,Chr. HTN etc FETAL IUFD postmaturity Fetal anomaly incompatible with life Severe IUGR Rh isoimmunisation Macrosomia
  • 4. Severe degree CPD Major degree placenta previa Transverse lie or breech presentation Previous classical CS, Myomectomy Contracted pelvis Grand multipara or old primigravida Active genital herpes Hypersensitivity to the inducing agent CONTRAINDICATIONS
  • 5. Failure leading to CS Uterine hyperstimulation Fetal distress,death Rupture uterus Intrauterine infection,sepsis Iatrogenic delivery of preterm infant Precipitate/dysfunctional labour Inc. risk of operative vaginal delivery Inc. risk of birth trauma Inc. risk of PPH Complications
  • 6. Decision taken to induce labour Cervical status Bishop score Cervix ripes Cervix doesnt ripe Induce labour Ripe cervix then induce labour assessme nt
  • 8. Methods of cervical ripening natural mechanical pharmacological Walking Having sex Nipple stimulation Enema Acupressu re Hygroscopi c dilators Transcervic al catheter Stripping the membranes Prostaglandin E2: (dinoproston e) Prostaglandin E1
  • 10. Methods of induction labour Surgical Pharmacological Amniotomy Oxytocin prostaglandins
  • 12. Adminstration IV infusion Advantages: it is potent and easy to titrate, Has a short half-life (one to five minutes) Well tolerated.
  • 13. Oxytocin infusion should be given in the smallest possible volume, commencing at a rate of 1 mU/min Usually start by 5 units in 500mls of normal saline or Ringers solution [10 mU/ml] Increase infusion rate (by doubling drops / min) at intervals of 30 min, until there are 3-5 good contractions every 10 min each lasting 45-60 sec. [1 ml=15-drops] If 60 drop/min rate is reached with no efficient contractions replace the infusion with 10 units oxytocin in 500 mls Total dose of oxytocin should not exceed 5 units Oxytocin Regimen: