Induction of Labor
Induction of Labor
Induction of Labor
OF LABOR
PRESENTED BY:
Ms. Bhagyashree Dash
Here starts
the lesson! M.Sc. Nursing 2nd year
Obstetric & gynecological Nursing
OBJECTIVES
Today’s lesson objectives are-
1. Cervical status
2. Ultrasound
3. Biochemical
4. Others
PRE-INDUCTION OF
CERVICAL RIPENING
Induction may be indicated even when the cervix is
unfavorable or unripe (Bishop score <6. In these
cases, techniques for cervical ripening are utilized.
It is of 2 types-
Low rupture of the membranes (LRM)
High rupture of the membranes
(HRM/ARM)
ARTIFICIAL RUPTURE OF MEMBRANE
Advantages of amniotomy:
(a)High success rate;
(b)Chance to observe the amniotic fluid for blood or
meconium;
(c)Access to use fetal scalp electrode or intrauterine
pressure catheter or for fetal scalp blood sampling.
Indications:
Patient should be in bed
Monitoring of uterine contractions
Monitoring of fetal heart rate
Monitoring of drug use (Oxytocin dose
increment/Repeat dose for PGs)
Immediate beneficial effects of
ARM
Lowering of the blood pressure in pre-eclampsia,
eclampsia.
Delivery is
completed within 12 Epidural analgesia
hours of admission
Fetal monitoring
Aim:
To expedite delivery within 12 hours
without increasing maternal morbidity and
perinatal hazards.
Active
management
of labor
Objective (a)Early detection of any
delay in labor;
(b)Diagnose its cause;
and
(c)Initiate management.
Advantages and Contraindications of
Active Management of Labor
Advantages Contraindications
• Less chance of dysfunctional labor Presence of obstetric complication
• Shortens the duration of labor (<12
hours) Presence of fetal compromise
• Fetal hypoxia can be detected
early Multigravida (not a routine)
• Low incidence of cesarean birth
• Less analgesia
• Less maternal anxiety due to
support of the caregiver and
prenatal education.
RELATED
RESEARC
H
Prevalence, outcomes and associated factors of labor induction among women delivered
at public hospitals of MEKELLE town-(a hospital based cross sectional study)
AUTHOR:
Garang Dakjur Lueth,
Angesom Kebede &
Araya Abrha Medhanyie
JOURNAL:
BMC Pregnancy and Childbirth volume 20, Article number: 203 (2020)
A hospital based cross sectional study was conducted on 346 laboring mothers who delivered
after induction of labor, from January 1st, to July 31st, 2017. Using structured questionnaire and
quota sampling techniques.
RESULT:
Out of 346, 244 (70.5%) delivered vaginally, 19 (5.5%) were instrumental deliveries and 83
(24%) by Cesarean section, induction was successful in 263 (76%) while the failure rate was 25
(7.2%).
All who failed induction (25) were delivered by cesarean section making a 3.3% contribution of
failed induction into the overall rate of the institutions cesarean deliveries during the study period.
Prolonged rupture of membranes was the commonest indication
Induction of Labour among Pregnant Women in the Department of Obstetrics and
Gynaecology in a Tertiary Care Centre
JOURNAL:
JNMA J Nepal Med Assoc. 2023 Sep; 61(265): 687–690.
Siddhartha Kumar Yadav, 1 Indra Yadav, 1 Tarun Pradhan, 1 Sabita Jyoti, 2 and Rozy Yadav 3
A descriptive cross-sectional study was conducted among pregnant women in a tertiary care
centre from 3 February 2022 to 31 July 2022.
RESULT:
Among 1355 pregnant women, the prevalence of induction of labour was found to be 135 (9.96%)
SUMMA
RY
CONCLUSIO Induction of labor means
initiation of uterine contractions
N
(after fetal viability) for the purpose
of vaginal delivery.
There is rise in the incidence of
induction of labor globally (US:
23.4%, UK: 21%, Asian countries
12.1%, Sri Lanka: 35.5%)
Induction of labor should be
done when benefits of delivery to
either the mother or the baby
outweigh the risks of pregnancy
BIBLIOGRAPHY
1. Dutta DC. Textbook of Obstetrics:Induction of labor.9 th edition.Nepal:Jaypee
Publishers;2019.page no-487-493
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4. Editor. Bishop score and modified bishop score in obstetrics – medchrome
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https://medchrome.com/major/gynaeobstr/bishop-score-and-modified-bishop-score/
5. Lueth GD, Kebede A, Medhanyie AA. Prevalence, outcomes and associated factors
of labor induction among women delivered at public hospitals of MEKELLE town-(a
hospital based cross sectional study). BMC Pregnancy and Childbirth [Internet].
2020 Apr 9;20(1). Available from: https://doi.org/10.1186/s12884-020-02862-7
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Women in the Department of Obstetrics and Gynaecology in a Tertiary Care Centre.
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Available from: https://doi.org/10.31729/jnma.8255
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