- What is it?
- Labour Induction
- Team and structure
Performing Labour Induction
Labour induction/cervical ripening can be done in several ways:
- Rupture of the amniotic sac.
- Insertion of a mechanical device at the level of the cervix to promote dilation, without releasing medication.
- Administration of a device at the level of the cervix that releases medication (prostaglandins) and promotes dilation.
- Administration of oral tablets (prostaglandins) that promote dilation.
- Administration of a hormone perfusion (oxytocin) that produces contractions. This can be done at the beginning or after any of the previous techniques.
Labour induction contraindications
Contraindications to inducing labour are situations that make a vaginal delivery difficult. The most common in our setting are: 2 or more previous caesarean sections, a previous caesarean section with an inverted T incision; previous myomectomy with entry into the uterine cavity; history of uterine rupture; complete placenta previa; vasa previa; severe placental insufficiency; and infection by active genital herpes.
Complications of labour induction
Although the induction/ripening procedure is used frequently and its risks are not high, complications may occasionally appear, especially in first pregnancies. Thus, before it is decided to induce a pregnancy, there must be strong maternal or foetal reasons for doing so.
When foetal well-being is compromised, induction fails or uterine rupture occurs (rarely), a caesarean section is performed.
Labour induction in patients with a previous caesarean section
Because an earlier caesarean section leaves a scar in the uterus, there is a risk of uterine dehiscence and/or rupture. Its frequency is estimated at around 0.5% of cases. This risk of uterine rupture and/or dehiscence increases (to about 2%) if labour is induced. However, a vaginal delivery after a caesarean section does not have the short- and long-term complications associated with repeat caesarean sections.
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