by dr.Sohayla Mahmoud Felfel student at obstetric and gynecology department Alexandria University

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 doesn’t 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

11. Oxytocin
MECHANISM

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 Ringer’s 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: