Induction of Labor “IOL”

Induction of Labor “IOL”

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Induction of labour is usually undertaken if the risks of continuing the pregnancy are greater than the risks of induction to deliver the baby.

Some indications for IOL include:

  • The pregnancy is past the due date
  • The mother has a health condition (high blood pressure or diabetes)
  • The bag of waters (amniotic membranes) has ruptured but labour has not started
  • The placenta is not working properly
  • The baby’s growth is slowing
  • The baby has a health condition and needs medical treatment
  • Psychosocial reasons

The woman’s experience during induced labour is usually similar to natural labour.

Augmented labour: Sometimes, labour starts naturally but fails to progress because of weak or ineffective contractions. Natural labour can be helped along by some induction methods. This is called “augmented labour”.

Induction Methods

Before induction, vaginal examination is performed to find out whether the cervix has opened (dilated). The state of the cervix helps to determine which induction method is best.

All induction methods aim to stimulate the onset of labour and contractions of the uterus.

When the chosen’ induction method does not work, a Caesarean section may be considered to deliver the baby.

Stripping of membranes – A sterile gloved and lubricated finger is used to gently separate the amniotic membrane from the cervix. This increases the body’s own prostaglandin levels and may help to dilate and soften the cervix.

Prostaglandin – This is a natural hormone that softens the cervix. During a vaginal examination, the prostaglandin is placed around the cervix. It may be inserted as a gel or Pessary in the evening to dilate the cervix overnight. Sometimes two doses are needed.

Balloon catheter – A thin catheter is placed at the cervix. Once In place, the little balloon at the end is inflated with water. The constant pressure exerted against the cervix may help it to dilate and soften.

Amniotomy (Artificial rupture of membranes, ARM) – A slender instrument (Amniohook) or a small hook on a gloved finger is used to break the amniotic membrane. This may trigger the onset of labour.

Oxytocin – During labour, the hormone Oxytocin is secreted naturally from the pituitary gland in the brain. In hospital, synthetic Oxytocin can be administered through an intravenous drip inserted into the woman’s arm. The dose is slowly increased until the uterus contracts efficiently.

Possible Complications of IOL

IOL is safe; however, all surgical and medical treatments carry some degree of risk. While every attempt is made to minimise risks, complications may occur.

It is not possible to outline every possible side effect or rare complication of treatment. However, it is important that you have enough information about possible complications to fully weigh up the risks and benefits.

The following possible complications are listed to inform you, not to alarm you. There may be other complications that are not listed.

  • The induction may not work. You may need to have a Caesarean section
  • Prostaglandin and Oxytocin increase the risks of uterine over stimulation, which can distress the baby
    • Sometimes an emergency Caesarean section is needed
    • Uncommonly, uterine rupture may occur, requiring blood transfusion and hysterectomy
    • Rarely, uterine rupture may lead to amniotic fluid leaking into the mother’s blood stream. A resulting amniotic-fluid embolism may trigger shock or a heart attack.
  • Oxytocin slightly increases the risk of uterine rupture in women who are trying to give birth vaginally after a previous Caesarean section. This can be a life-threatening complication for both mother and baby.
  • The main risks of stripping the membranes are bleeding and infection, bur these complications are rare.
  • Amniotomy increases the risk of:
    • Cord Prolapse. The umbilical cord may protrude from the cervix before the baby is born. An emergency Caesarean section may be needed
  • A balloon catheter or similar device increases the risks of bleeding and infection.

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