Various methods of induction-of-labour(0) (1).ppt

For medical professionals and Nursingand health professionals.
It describes various methods for induction of labour used in labour room.

1. INDUCTION OF
LABOUR

2. DEFINITION
Inductionoflabourmeansdeliberatetermination
ofpregnancybeyond28weeks(Periodofviability)
byanymethodwhichaimsatinitiationoflabourand
avaginaldelivery.

3. Indications
Fetal
Maternal
Combined
Post maturity
History of IUD
DM
IUGR
Rh-isoimmunisation
Unstable lie
Fetal
IUD
Chronic polyhydramnios
Congenital malformations Maternal
Pre –eclampsia
Minor degree of placenta praveia
Abruptio placenta
PROM
Chronic HTN
Chronic renal disease
Combined

4. CONTRAINDICATIONS
Contracted pelvis and CPD
Persistent malpresentation
Pregnancy with previous caesarean section
Elderly primigravida
Heart disease
High risk pregnancy with compromised fetus
Pelvic tumour

5. SUCCESS OF INDUCTION depends on
Period of gestation
Case profile
Sensitivity of the uterus
Pre induction scoring

6. METHODS OF INDUCTION
Medical
Drugs used oxytocin, prostaglandins
LRM
AROM HRM
Surgical
Stripping of membranes
Combined

7. Merits and demerits of each method
Prostaglandin
Advantages
Effective method in IUD or cases with unfavourable cervix
No antidiuretic effect
Drawbacks
More systemic side effects when used orally or I/V
Hyper stimulation

8. OXYTOCIN
Advantages
Wider availability
Less systemic side –effects
HAZARDS OF AROM
Cord prolapse
Uncontrolled escape of amniotic fluid
Injury to cervix or presenting part
Rupture of vasapraevia leading to fetal blood loss.
Amnionitis

9. Injurytotheplacenta
Accidentalinjurytotheuterinewall
Injurytothefetalpartsespeciallyeye.
Displacementofpresentingpart
Intra–ammoticinfection
Longerinduction–deliveryintervalcomparedtoLRM

10. SCHEME OF INDUCTION PROTOCOL
CX –favourable
Surgical
Medical
CX –unfavourable
Oxytocin or
prostaglandin E
2
Prostaglandin more
effective
LRM
HRM
•APH
•Severe PIH
•Eclampsia
Ch.
Polyhydramnios
Combined
(common)
CX –unfavourable
Prostaglandin E
2gel/
Oxytocin infusion
Cervix –ripe
LRM + OXYTOCIN
CX –favourable
LRM + OXYTOCIN

11. NURSING CARE
Technique of oxytocin administration
Indications for stopping the drip
Nursing measures Consent, explain to the patient
Monitoring
Supervision and recording of findings
Pain relief

12. Observation
Rate of flow
Uterine contractions
FHR
Progress of labor
Maternal conditions
-Vital signs
-Urine for ketoacidasis
-Intake and output chart
-Watch for prolapse of cord