الفهرس | Only 14 pages are availabe for public view |
Abstract Induction of labour: An intervention designed to artificially initiate uterine contractions leading to progressive dilatation and effacement of the cervix and birth of the baby. This includes both women with intact membranes and women with spontaneous rupture of the membranes but who are not in labour. The term is usually restricted to pregnancies at gestations greater than the legal definition of fetal viability (RCOG, 2001). Induction is indicated when the risk of continuing the pregnancy, for the mother or the fetus, exceeds the risk associated with induced labour and delivery. The indication must be convincing, compelling, consented to, and documented. The reason for and method of induction should be discussed between the care provider and the woman in order to obtain clear consent. These conditions are not met when induction is proposed solely for the convenience of the care provider or patient. Induction should be prioritized by the health care team according to the urgency of the clinical situation and the availability of resources. Induction is indicated in response to a number of fetal and maternal situations including preeclampsia ≥ 37 weeks , Chorioamnionitis , suspected fetal compromise , term pre-labour rupture of membranes , postdates (> 41+0 weeks) or post-term (> 42+0 weeks) pregnancy, diabetes mellitus (glucose control may dictate urgency) ,alloimmune disease at or near term , Intrauterine growth restriction , oligohydramnios, gestational hypertension ≥ 38 weeks , Intrauterine fetal death , PROM at or near term, GBS negative , logistical problems (history of rapid labour, distance to hospital) and intrauterine death in a prior pregnancy (Induction may be performed to alleviate parental anxiety, but there is no known medical or outcome advantage for mother or baby.) |