Induction of lbour
Induction of lbour
What is induction of labour
Articfial initiation of labour before spontenous onset of
labour,when continuation of pregnancy no longer safe for fetous or mother
Indication for induction of labour
- Past dates
- Post dates
- IUGR
- Oligohydroamniosis
- Pre eclampsia
- Diabetes mellitus
- Twin pregnancy continuing beyond 38 weeks
- Rh iso immunization
Contra indication for induction of labour
Any contraindication for vaginal delivery is contraindicate
for inducation of labour
1 .Cephalo pelvic
disproportion
- Short mother
- Large baby
- Contracted pelvis
2.Breech presentation
,
3. Transverse lie
4. Major degree placenta previa
5. Past history of LSCS ( scard uterus )
Method / procedure of induction of labour
Method of induction depends on the favorability of cervix
for vaginal delivery . favorability of
cervix for vaginal delivery asses by using bisops score
Score
|
0
|
1
|
2
|
3
|
Dilatation
( cm)
|
0
|
1-2
|
3- 4
|
5 -10
|
Effacement %
|
0 -30
|
40 - 60
|
60 - 70
|
80
|
Station
|
-3
|
-2
|
-1/0
|
+1/+2
|
Consistency
|
Firm
|
Medium
|
Soft
|
|
Posistion
|
posterior
|
Central
|
Anterior
|
- If the bishops score is less than 6 , then the cervix is considered as unfavorable for induction
- If the bishops score between 6 – 9 , cervix is favorable for induction
- If the bishops score more than 9 , it is considered as already in labour
When cervix unfavorable the cervix has to be ripened .
Ripening of cervix
Non pharmacological methord
- Artificial separation of membrane ( ASOM)
- Foley catheter to induce labor
Pharmacological methords
- Prostoglandins – Dinoprostone gels / Dinoprostone vaginal pessary
- Antiprogestornes – Mifepristone
If the cervix is favorable and
membranes are intact , induction of laboure should be done by performing
artificial rupture of membrane ( ARM )
In the absence of adequate uterine
contractions augmentation
of labour should be done by using oxytocin ( syntocinon) infusion .
Oxytocin 5 U in Primi mother and 2 U in
mulitigravid mother added to 1 pint of ( 500 ml ) of normal saline and infused
at a rate of 15 drpos per minute . in the absence of adequate contraction ( 3
uterine contraction for 10 minute ) increase drop rate by 15 drops minute in
every 30 minute maximum upto 60 drops per minute . mean time monior mother for
uterine hyperstimulation
Complication of i
Category: Gynacology and obstetrics
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