for students of Obstetrics - brief overview of labor induction.

1. INDUCTION OF
LABOR
Mini Sood

2. OBJECTIVE
S
Define induction of labor
List the indications –Maternal and Fetal
List the Contraindications – Maternal and
Fetal
Describe the methods- Medical and
Surgical
Discuss risks.

3. DEFINITION
OF
INDUCTION
OF LABOR
Induction of labor is defined as the
artificial initiation of uterine contractions
before the spontaneoud onset of labor.
Augmentation is the stimulation or
spontaneous contractions that are
considered inadequate , as there is no
cervical changes or fetal descent.

4. INDICATION
–
MATERNAL
AND FETAL
Hypertensive disorders of pregnancy
Diabetes in pregnancy
Renal disease
Chronic pulmonary disease
PPROM
Chorioamnionitis
Fetal growth restriction
RH isoimmunisation

5. CONTRAINDICA
TIONS OF IOL
Macrosomia
CPD
Obstetric
contraindications to a
vaginal delivery

6. METHODS
OF IOL
Mechanical methods
1. ARM-Artificial rupture of
membranes
2. Foley’s catheter insertion
3. Dilapan insertion- seaweed
pessary

7. FACTORS
THAT HELP
Factors to determine favourability for IOL
1. FETAL PRESENTATION
2. Pelvic shape and size
3. Bishop’s score
4. Fetal size
5. Uterine contractions

8. ARTIFICIAL
RUPTURE
OF
MEMBRANE
S
Amnitomy
Done after bag of membrane is formed and
head is fixed in the pelvic cavity
Benefits
Does speed up the contractions and
shortens the induction delivery interval
Risks
Ascending infection
Abruptio placenta
Cord compression
Cord prolapse

9. METHODS
Cervical ripening

10. MEDICAL
METHODS
OF IOL
1. Oxytocin
2. Prostaglandins
Benefits
Vaginal delivery
Risks
1. Hyperstimulation
2. fetal distress
3. Early membrane rupture
4. Failed induction

11. OXYTOCIN
Action
Acts directly on myofibrils producing uterine
contractions and stimulating milk ejection
from the breast.
Side effects-Hypo or hypertension,
dysrhythmia, abruptio placenta, decreases
uterine blood flow, convulsions, nausea,
vomiting and asphyxia of baby.

12. OXYTOCIN
Nursing role
1. Assess maternal vitals, abdomen and
pelvic exam
2. Fetal heart rate monitoring
3. signs of water intoxication
4. educate patient on reporting any blood
loss, abdominal cramping, fever or foul
smelling lochia.

13. CONTRAINDICAT
IONS TO
OXYTOCIN USE
Fetal distress
Abnormal fetal presentation
Prematurity
CPD
Placenta previa
Cord presentation

14. DRUGS
THAT
AFFECT
UTERINE
FUNCTION
1. Tocolytic drugs- ridodrine, magnesium
sulphate, nefidipine
2. Tranexamin acid
3. Prostaglandins
4. NSAIDS
5. Ergot alkaloids

15. SUMMARY
CASE

16. THANK YOU