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Induction of labor

                         

Induction of labor is the artificial induction of labor mechanism prior to its spontaneous onset. Or is the stimulation of uterine contractions during pregnancy before labor begins on its own to achieve a vaginal birth.

Indication

  • Prolonged gestation: pregnancies extending beyond 42 weeks.
  • Premature rupture of membrane
  • Maternal health problem
  • Fetal growth restriction
  • Intrauterine  fetal death
  • Placental abruption
  • Gestational diabetes

Contraindications

  • Placenta previa
  • Breech presentation
  • Previous c-section

Methods

  1.   Medical methods
  2. Prostaglandins: Prostaglandins act to prepare the cervix for labor by ripening it, and also have a role in the contraction of the smooth muscle of the uterus. PGE2 and PGE3. PGE2b is primarily for ripening of cervix.
  3. Oxytocin: stimulate uterine contraction
  4. Mefipristone: Blocks both progesterone and glucocorticoid receptors. Can be used transvaginally or orally.
  • Surgical methods
  • ARM (Artificial rupture of membrane): An amniotomy is where the membranes are ruptured artificially using an instrument called an amnihook.  An amniotomy is done only if the cervix is partially dilated and thinned and the baby's head is deep in the pelvis.
  • Stripping the membrane: Means separation of chrioamniotic membranes from wall of cervix and lower uterine segment. It’s safe and beneficial for induction of labor.

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