Methods of Induction of Labor

Different methods of induction of labour are:

Membrane Sweeping

This method is only performed at term and placenta previa is ruled out prior to the procedure. After cervix begins to dilate, a gloved finger is inserted through the cervix and is rotated around the inner rim of cervix. In this method chorionic membrane is stripped off from underlying decidua which causes release of natural prostaglandins.

Prostaglandin

Prostaglandin is available in form of gel, pessary, or tablet. PG E2 is the most common formulation. It can be inserted vaginally into the cervix to ripen cervix and initiate contractions.

Artificial rupture of membranes

Prostaglandin alone may not be sufficient for a successful induction of labour especially in primiparous women. In cases Artificial rupture of Membranes and Oxytocin are used.

Oxytocin

Oxytocin can be used after rupture of membranes. It is given in IV infusion as dilute solution.

3-5 contractions every 10 minutes is desirable. For this infusion is started at a low rate and small increments are made every 30 minutes till the desired contractions are achieved.

If there are >5 contractions every 10 minutes then the oxytocin should be stopped and if necessary a tocolytic drug subcutaneous terbutaline is administered.

Mifepristone and Misoprostol

This drug combination is used for induction of labour only in cases of Intrauterine fetal death.

Tags: medical student guidebook, easy medical school notes, gynae & obs, obstetrics notes, handouts for medical students, gynaecology and obstetrics review notes for exam, labor, induction of labor various methods.

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