contractions are achieved(3–5 or a rate of contractions are achieved every 10 minutes.) 32 mU/min is reached While this is given, fetal heart rate & uterine activity is monitored. If contractions are high (excessive uterine activity) but there is normal fetal heart rate we decrease the dose. If excessive activity with abnormal heart rate we stop the induction & do the supportive measures of excessive activity that will be mentioned later. 3.Recommendation on amniotomy with intravenous oxytocin The combination of intravenous oxytocin and amniotomy is commonly used in women with favourable cervices. 4.Misoprostol is a synthetic prostaglandin E1 that can be given orally, vaginally or sublingually. It is effective in causing uterine contractions. However, misoprostol is currently not licensed for use in pregnancy in the UK. Side effects are diarrhoea and shivering, both of which are dose dependent and self-limiting & uterine hyperstimulation. Misoprostol has been widely recommended for the treatment of: Missed miscarriages Incomplete miscarriages Therapeutic termination of prgnancy. Pre-induction cervical ripening Cervical preparation before uterine instrumentation It also has potential in late pregnancy for induction of labour Postpartum haemorrhage prophylaxis and treatment . Most now agree that prior uterine surgery, including cesarean delivery, precludes misoprostol (Not recommended for cx- ripening in patients the use of who have a uterine scar). Misoprostol is not licensed for induction of labour in the UK, It should only be offered as a method of induction of labour to women who have intrauterine fetal death or in the context of a clinical trial. 5.Mifepristone Mifepristone, also known as RU 486, is an antiprogestin and has been developed to antagonise the action of progesterone. Mifepristone now has an established role in the termination of pregnancy, in combination with prostaglandins, during the first and second trimester.
contractions are achieved(3–5 contractions are achieved every 10 minutes.) or a rate of 32 mU/min is reached While this is given, fetal heart rate & uterine activity is monitored. If contractions are high (excessive uterine activity) but there is normal fetal heart rate we decrease the dose. If excessive activity with abnormal heart rate we stop the induction & do the supportive measures of excessive activity that will be mentioned later. 3.Recommendation on amniotomy with intravenous oxytocin The combination of intravenous oxytocin and amniotomy is commonly used in women with favourable cervices. 4.Misoprostol is a synthetic prostaglandin E1 that can be given orally, vaginally or sublingually. It is effective in causing uterine contractions. However, misoprostol is currently not licensed for use in pregnancy in the UK. Side effects are diarrhoea and shivering, both of which are dose dependent and self-limiting & uterine hyperstimulation. Misoprostol has been widely recommended for the treatment of: Missed miscarriages Incomplete miscarriages Therapeutic termination of prgnancy. Pre-induction cervical ripening Cervical preparation before uterine instrumentation It also has potential in late pregnancy for induction of labour Postpartum haemorrhage prophylaxis and treatment . Most now agree that prior uterine surgery, including cesarean delivery, precludes the use of misoprostol (Not recommended for cx- ripening in patients who have a uterine scar). Misoprostol is not licensed for induction of labour in the UK, It should only be offered as a method of induction of labour to women who have intrauterine fetal death or in the context of a clinical trial. 5.Mifepristone Mifepristone, also known as RU 486, is an antiprogestin and has been developed to antagonise the action of progesterone. Mifepristone now has an established role in the termination of pregnancy, in combination with prostaglandins, during the first and second trimester.
2_2016_12_27!09_14_14_AM.docx