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Induction Of Labour, All You Need To Know. - Health - Nairaland

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Induction Of Labour, All You Need To Know. by Kayus4real: 10:50am On Oct 10, 2017
About 10% of pregnancies need to be induced in order to expedite vaginal delivery. This happens when the benefits of delivering the baby outweighs the risks of continuing the pregnancy or awaiting spontaneous labour. *What are the indications for induction of labour? -Placental insufficiency : when the placenta is diseased and no longer capable of supporting the foetus -Prolonged pregnancy : beyond 41 weeks of gestation -Intrauterine growth restriction (IUGR) : when the foetus fails to gain weight, or loses weight due to constitutional, maternal or placental disease - Premature rupture of membranes : when the "bag of water" breaks without any sign of labour after 24 hours (to avoid infection to the baby) - Intrauterine fetal death - to prevent the risk of toxicity or infection to the mother - Intrauterine infection (Chorioamnionitis) - Unexplained antepartum hemorrhage - Potential or presumed fetal macrosomia : increasing growth beyond 4kg, especially in diabetic mothers - Medical diseases in the mother : such as severe hypertension, uncontrolled diabetes, cardiac or renal diseases, cancers, etc. *What are the methods for inducing labour? Before induction of labour, it is important to assess the cervix to determine its "ripeness", ie. to predict whether induction is likely to succeed or fail. Predictors of a successful induction includes advanced gestational age (above 37weeks) and multiparity (having delivered by vagina in the past). The cervix can be ripened through medical and non-medical methods. There is limited evidence to support the efficacy of non-medical methods (eg. Sexual intercourse, nipple stimulation, herbal mixtures, dates, castor oil, etc.) The medical methods of ripening are : 1. Mechanical methods - this includes using the finger to "stretch and sweep" the cervix and/or insertion of a catheter into the cervical canal. 2. Pharmacological methods - use of chemical agents (prostaglandins and oxytocin) ********** Certain parameters are used by the midwives/physicians to "score" the ripeness of the cervix. After satisfactory ripening, induction of labour proper begins. This can be done in one of two ways - ~Artificial rupture of membranes - Deliberately breaking the "bag of water", which stimulates the process of active labour through the release of prostaglandins. ~Induction/Augmentation of labour using oxytocin infusion - Oxytocin is released normally by the brain at the time of labour. This process can be augmented by infusion of controlled amount of oxytocin (Syntocinon®) through dedicated intravenous infusion pumps. *Note that induction of labour MUST be done in a hospital where adequate feto-maternal monitoring and standard obstetric care are available. This will ensure that any complication in the course of induction can be identified promptly and treated appropriately. It is also better to have standby facilities for Caeserean section in case of complications during, or failure of induction of labour. Wishing all expectant mothers safe delivery!
Re: Induction Of Labour, All You Need To Know. by ChelseaDr(m): 2:40pm On Oct 10, 2017
Kayus4real:

About 10% of pregnancies need to be induced in order to expedite
vaginal delivery. This happens when the benefits of delivering the
baby outweighs the risks of continuing the pregnancy or awaiting
spontaneous labour.
*What are the indications for induction of labour?
-Placental insufficiency : when the placenta is diseased and no longer
capable of supporting the foetus
-Prolonged pregnancy : beyond 41 weeks of gestation
-Intrauterine growth restriction (IUGR) : when the foetus fails to gain
weight, or loses weight due to constitutional, maternal or placental
disease
- Premature rupture of membranes : when the "bag of water" breaks
without any sign of labour after 24 hours (to avoid infection to the
baby)
- Intrauterine fetal death - to prevent the risk of toxicity or infection
to the mother
- Intrauterine infection (Chorioamnionitis)
- Unexplained antepartum hemorrhage
- Potential or presumed fetal macrosomia : increasing growth beyond
4kg, especially in diabetic mothers
- Medical diseases in the mother : such as severe hypertension,
uncontrolled diabetes, cardiac or renal diseases, cancers, etc.
*What are the methods for inducing labour?
Before induction of labour, it is important to assess the cervix to
determine its "ripeness", ie. to predict whether induction is likely to
succeed or fail. Predictors of a successful induction includes advanced
gestational age (above 37weeks) and multiparity (having delivered by
vagina in the past).
The cervix can be ripened through medical and non-medical methods.
There is limited evidence to support the efficacy of non-medical
methods (eg. Sexual intercourse, nipple stimulation, herbal mixtures,
dates, castor oil, etc.)
The medical methods of ripening are :
1. Mechanical methods - this includes using the finger to "stretch and
sweep" the cervix and/or insertion of a catheter into the cervical
canal.
2. Pharmacological methods - use of chemical agents (prostaglandins
and oxytocin)
**********
Certain parameters are used by the midwives/physicians to "score" the
ripeness of the cervix. After satisfactory ripening, induction of labour
proper begins. This can be done in one of two ways -
~Artificial rupture of membranes - Deliberately breaking the "bag of
water", which stimulates the process of active labour through the
release of prostaglandins.
~Induction/Augmentation of labour using oxytocin infusion - Oxytocin
is released normally by the brain at the time of labour. This process
can be augmented by infusion of controlled amount of oxytocin
(Syntocinon®) through dedicated intravenous infusion pumps.
*Note that induction of labour MUST be done in a hospital where
adequate feto-maternal monitoring and standard obstetric care are
available. This will ensure that any complication in the course of
induction can be identified promptly and treated appropriately.
It is also better to have standby facilities for Caeserean section in
case of complications during, or failure of induction of labour.
Wishing all expectant mothers safe delivery!

Op thanks for this information. I want to differ on some of the points you raised.

In writing about the indications for induction of labour, you mentioned macrosomia and antepartum haemorrhage. Foetal macrosomia means BIG baby. It is not an indication for induction of labour. The reason is because your aim of induction is for the woman to deliver vaginally and when BIG babies are coming of through the vagina, the labour is prone to be prolonged and tedious, the baby is prone to birth injuries (including features) and death, and even when they survive may have long term complications including poor performance in school, and various forms of brain injury including CEREBRAL PALSY.

Therefore, it is very risky to go inducing a pregnant woman with suspected or confirmed foetal macrosomia.

Antepartum haemorrhage is bleeding through the birth canal before birth. This is a serious emergency and no obstetrician or any other doctor will go about inducing a bleeding woman, that is medical malpractice. More so when the cause of the bleeding is not confirmed, it is dangerous. It could be placenta praevia (low placenta) or abruptio placentae(partially or completely detached placenta).

Please it is bad obstetrics practice to induce a a pregnant woman with APH. Thanks.
Cheers!!

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