Induction and augmentation of labor

What are indications of inducing a labor?

• PPROM

• Gestational hypertension

• Intrauterine fetal demise

• Labor dystocia 

• Post-term

What are contraindications to inducing a labor?

• Placenta previa

• Placental abruption

• Transverse or breech fetal position

• Prior “classical” uterine incision for surgical birth

• Active herpes infection

• Non-reassuring FHR pattern

Before starting an induction what will the nurse assess?

 fetal presentation, gestational age, estimated fetal weight, cervical dilation, and fetal heart rate tracing.

Name induction methods

Mechanical: AROM(hook), Foley Balloon

chemical: misoprostol, oxytocin

Non-pharmacological: sexual intercourse and nipple stimulation

What is the purpose of misoprostol?

meant for cervical ripening (soften the cervix and help it to be more favorable for labor)

What is the purpose of oxytocin?

increases strength and frequency of contractions

What is the most common adverse affect of oxytocin?

Uterine hyperstimulation and impaired oxygenation

Can also be seen as tachystole for contractions

What effect does oxytocin have on the body and what does it result in?

Antidiuretic effect which results in decreases UO(may lead to water intoxication)

What is always ran with oxytocin?

A fluid bolus to counteract hypotension but contraindicated with preeclampsia

What does AROM do to induce labor?

(artificial rupture of membranes) – releases prostaglandins and helps baby to put more direct pressure on the cervix