Induction of labour (IOL) Dr.Miami Abdul Hassan 4th.class F.I.C.O.G Assistant professor 2014-2015 Definition: (IOL) is the stimulation of uterine contractions or artificial or planned initiation of labour before its spontaneous onset for the purpose of delivery of the fetoplacental unit. The rate of induction of labour varies by location & institution but appear to be increasing. Indications: Induction of labour should be considered when it is felt that the benefits of vaginal delivery out weight the potential maternal & fetal risk of induction. These issues should be discussed with the women prior to initiation of induction. The most common indications for induction: 1.Post term or prolonged pregnancy . This is the most common reason for IOL.. women are usually recommended IOL between 41 and 42 weeks gestation 2.Pre-labor rupture of membrane (P.R.O.M.) 3.Potential fetal compromise (significant fetal growth restriction, non-reassuring fetal surveillance). 4.Pre-eclmpsia. 5.Other maternal hypertensive disease. 6.Intra-hepatic cholestasis of pregnancy. 7.Autoimmune disease e.g. (SLE). 8.Maternal medical conditions: (Diabetes mellitus, Renal disease, significant pulmonary disease). 9.Rhesus iso- immunization. 10Twin pregnancy continuing beyond 38 weeks. 11.Recurrent antepartum hemorrhage. 12.Intrauterine fetal demise. 13.Sometime induction done for social or geographic reasons without a medical or obstetrical indication. However elective induction should be discouraged with nulliparous women since the rate of caesarean delivery is increasing with elective induction. Complications of IOL. Potential risks of induction include: (1).failed induction: is defined as failure to establish labour after one cycle of treatment, if the cervix fail to dilate beyond 3cm after an ARM has been
Induction of labour (IOL) Dr.Miami Abdul Hassan 4th.class F.I.C.O.G Assistant professor 2014-2015 Definition: (IOL) is the stimulation of uterine contractions or artificial or planned initiation of labour before its spontaneous onset for the purpose of delivery of the fetoplacental unit. The rate of induction of labour varies by location & institution but appear to be increasing. Indications: Induction of labour should be considered when it is felt that the benefits of vaginal delivery out weight the potential maternal & fetal risk of induction. These issues should be discussed with the women prior to initiation of induction. The most common indications for induction: 1.Post term or prolonged pregnancy . This is the most common reason for IOL.. women are usually recommended IOL between 41 and 42 weeks gestation 2.Pre-labor rupture of membrane (P.R.O.M.) 3.Potential fetal compromise (significant fetal growth restriction, non-reassuring fetal surveillance). 4.Pre-eclmpsia. 5.Other maternal hypertensive disease. 6.Intra-hepatic cholestasis of pregnancy. 7.Autoimmune disease e.g. (SLE). 8.Maternal medical conditions: (Diabetes mellitus, Renal disease, significant pulmonary disease). 9.Rhesus iso- immunization. 10Twin pregnancy continuing beyond 38 weeks. 11.Recurrent antepartum hemorrhage. 12.Intrauterine fetal demise. 13.Sometime induction done for social or geographic reasons without a medical or obstetrical indication. However elective induction should be discouraged with nulliparous women since the rate of caesarean delivery is increasing with elective induction. Complications of IOL. Potential risks of induction include: (1).failed induction: is defined as failure to establish labour after one cycle of treatment, if the cervix fail to dilate beyond 3cm after an ARM has been