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Presentaion induction of labour

induction of labour

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Presentaion induction of labour

  1. 1. PRESENTED BY:- ABHILASHA VERMA M.Sc. Prev. PRESENTATION ON INDUCTION OF LABOUR
  2. 2. DEFINITION: INDUCTION- “It is defined as artificial stimulation of uterine contraction before the spontaneous onset of labor with aim of achieving delivery by any method i.e medical, surgical and combined methods” AUGMENTATION- “Stimulation of spontaneous uterine contractions both in frequency and intensity, that are considered inadequate because of failed cervical dilation and fetal descent”
  3. 3. INDICATION: i) Maternal medical complication:  Pregnancy induced hypertension ( Precelampsia & Eclampsia)  Diabetes mellitus  Cholestasis of pregnancy ii) Postmaturity iii) Abruptio placentae iv) IUGR v) IUFD vi) PROM vii) Major congenital abnormalilty viii) Unstable lie after correction into longitudinal lie
  4. 4. CONTRAINDICATION: I) Contracted pelvis & cephalo-pelvic disproportion. II) Malpresentation ( Breech, transverse or oblique lie) III) Previous hysterotomy. IV) Unexplained vaginal bleeding, vasa previa & placenta previa. V) Active genital herpes infection. VI) High risk pregnancy with fetal compromise VII) Pelvic tumor VIII) Elderly primigravida with obstetric or medical complication. IX) Cervical carcinoma.
  5. 5. RISKS: i) Maternal Risk- •Psychological upset, Failure leading to Cesarean section •Uterine hyper-stimulation •Rupture uterus •Intrauterine infection, Chorio-amnionitis •Precipitate labor •Increased risk of operative vaginal delivery •Increased risk of post partum hemorrhage •Abruptio Placentae •APH
  6. 6. Fetal Risk: •Fetal distress . •Fetal death •Neonatal sepsis •Iatrogenic delivery of a preterm infant •Cord prolapse •Increased risk of birth trauma •Hypoxia due to uterine dysfunction.
  7. 7. CRITARIA FOR INDUCTION OF LABOR: i) MATERNAL-  Confirm maternal indication for induction.  Review contraindication to vaginal delivery.  Perform clinical pelvimetery to assess shape and adequacy of pelvis.  Assess BISHOP score ( Score > 6, favorable)  Adequate counselling about risks, benefits, alternative of induction of labour. ii) FETAL-  Ensure fetal gestational age  Estimate fetal weight  Ensure fetal lung maturation status.  Ensure fetal presentation & lie.  Confirm fetal wellbeing.
  8. 8. BISHOP- SCORING
  9. 9. METHOD OF INDUCTION OF LABOR: MECHANICAL COMBINEDSURGICAL MEDICAL
  10. 10. MECHANICAL METHODS i) Hygroscopic dialators ii) Balloon dialators.
  11. 11. iii) MEMBRANE SWEEP
  12. 12. MEDICAL METHODS:- Drugs used are:- Prostaglandins Oxytocin
  13. 13. S.N DRUG NAME TRADE NAME ROUTE DOSES 1 PROSTAGLANDINS i) Cervigel ii) Dinoripe iii) Prepidil Intra Cervical (Gel form) Intravaginal gel form 0.5 mg PGE2 Maximum dose 1.5 mg/ 24 hours. 2.5 mg PGE2 Max. dose 5mg. 2. OXYTOCIN SYNTOCIN IV low dose 1-2 miliUnit/Min High dose =8 mili unit / min .
  14. 14. SURGICAL METHOD ARTIFICIAL RUPTURE OF MEMBRANE
  15. 15. ARTIFICIAL RUPTURE OF MEMBRANE • Membranes are ruptured by using a specialized tool, i.e amnii hook , amnicot to induce or accelerate labour. • Mechanism of action- i) Stretching of cervix ii) Separation of membrane iii) Release of prostaglandins iv) Reduction of amniotic fluid volume.
  16. 16. ARTIFECIAL RUPTURE OF MEMBRANE
  17. 17. COMBINED METHOD • Combined mechanical, medical, and surgical methods are used to increase effecacy of induction by reducing the induction-delivery interval.

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