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If your labor doesn't start on its own, your doctor may induce labor with medication or other techniques to induce contractions. This method helps pregnant women to have a normal labor and delivery.
1. Induction of labor
Induction of labor is a process where the doctor will stimulate uterine contractions to help a pregnant woman give birth through the vagina. There are many reasons for doctors to perform labor induction, some of the most common being due to overdue pregnancy, and doctors think it is better to have a baby now than to wait for natural labor or the water to break. .
Certain medical conditions such as high blood pressure, diabetes, heart or lung problems in a pregnant woman can also cause the doctor to perform labor induction. If there are any signs of fetal distress or stillbirth , as well as if you live too far from the hospital or have a history of rapid labor , your doctor may also recommend induction of labor . These are just a few of the common reasons your doctor will order induction of labor.
The success of labor induction for vaginal delivery will depend on many factors, one of which is cervical dilation and clearance. If a woman's cervix has a greater dilation and clearance, the more likely it is to have a vaginal birth. Your doctor may prescribe medication to ripen the cervix before induction of labor.
2. When is labor induction indicated?
Doctors can prescribe induction of labor for pregnant women when:
One to two weeks past the due date but the mother still has no signs of labor. Experts advise against waiting any longer as that puts both mother and baby at higher risk for a variety of problems. For example, the placenta's ability to deliver nutrients to the baby becomes less efficient, increasing the risk of stillbirth or other serious problems for the newborn. Amniotic fluid broke but still no sign of labor. Once the membranes have ruptured, you and your baby are at increased risk of infection. So the doctor will ask the mother to weigh the risks and benefits of inducing labor. The test results show that the mother's placenta is no longer functioning properly, has aged degeneration and cannot provide oxygen and nutrients to the developing fetus, the mother has too little amniotic fluid or the baby is not developing. as usual. You have preeclampsia, a serious condition that can endanger the mother's health and restrict blood flow to the fetus. The mother has a chronic or acute illness such as high blood pressure, diabetes, kidney disease or cholestasis of pregnancy, which threatens the health of the mother or the fetus. Previously had a stillbirth, fetal growth retardation. Or because the mother lives far from the hospital, the transportation is not convenient. Pregnant women have uterine infections, affecting the development of the fetus.
Bác sĩ có thể chỉ định kích thích chuyển dạ khi quá ngày dự sinh một đến hai tuần nhưng người mẹ vẫn chưa có dấu hiệu chuyển dạ
3. Contraindications
Test results indicate that the fetus cannot tolerate uterine contractions. There is placenta previa, prolapse of the umbilical cord. Pregnancy in breech position, fetal distress, severe hydrocephalus. You have had a previous cesarean section with a longitudinal incision in your uterus, or have had other uterine surgeries such as surgery to remove fibroids. Pregnant with twins and the first baby in the breech position, or are pregnant with multiples. Infection with genital herpes. The mother's serious chronic diseases such as heart failure, severe preeclampsia,... Fetal-pelvic mismatch of the mother. Unexplained third trimester vaginal bleeding.
4. Methods of induction of labor
There are many ways to induce labor, if cervical ripening (softening procedure) is needed, the doctor will put medicine into the woman's vagina. This medicine will slowly seep into the cervix. At the same time, the doctor may also prescribe oral medication to soften the cervix. These drugs are called prostaglandins and have effects similar to those of natural substances in the body. The two most commonly used prostaglandins are PGE1 and PGE2 in pill, gel, or vaginal suppositories.
There are also mechanical methods to dilate and soften the cervix. Foley catheterization method, this catheter is inserted into the woman's cervix to manually dilate the cervix. This device is like a water balloon with a diameter of about 5 to 8cm that helps to slowly open and soften the cervix. There is also a method of cervical dilation called laminaria, which is placed into the cervix to slowly open the cervix. These methods are usually applied in case of overdue pregnancy.
When the cervix is soft, the doctor will give oxytocin medicine intravenously to stimulate the uterus to contract for natural labor. Oxytocin will be gradually increased to help the contractions become strong enough to open the cervix.
Sometimes medication that softens the cervix will also cause uterine contractions. At that time, the doctor may not need to prescribe the drug intravenously if the uterus is already contracting and the cervix is gradually dilating.
In addition, the doctor may conduct amniocentesis (break the water) to stimulate contractions. This is an effective method to stimulate contractions and can be done in combination with the methods mentioned above.
Có nhiều cách để khởi phát chuyển dạ
5. Risks of labor induction
As mentioned above, labor induction does not always result in vaginal delivery. Sometimes a doctor needs to perform a cesarean section despite all efforts. The success of labor induction depends on the actual situation when induction is performed.
In addition, induction of labor can also lead to a vaginal delivery by a procedure such as forceps or aspiration.
For pain at the onset of labor, your doctor may prescribe an intravenous pain reliever or an epidural, depending on the stage of labor. However, these methods cannot completely relieve pain.
After labor begins, your doctor will check to see if your cervix is open. Induction of labor, if successful, results in a vaginal delivery and, if unsuccessful, a cesarean section may be required. The procedure to induce labor ends after the woman gives birth, whether by vaginal delivery or by cesarean section.
All procedures, no matter how complicated or how long, have unforeseen problems that can occur immediately or after the procedure. Because there are different methods for inducing labor or softening the cervix, complications will depend on the method performed. Those complications include, but are not limited to:
5.1. Complications caused by prostaglandins (medicines that soften or ripen the cervix) Hypertonic contractions: A condition in which the uterus contracts too much in a period of 10 minutes. This condition is also accompanied by signs that the fetus cannot tolerate this type of mound. The rate of intense contractions for PGE2 gel is about 1% if inserted vaginally and 5% if placed intracervically. The risk of PGE1 has not been established, but may be slightly higher than that of PGE2; Side effects for pregnant women: Because the drug is absorbed into the bloodstream, women may experience diarrhea, fever, or vomiting. But this risk is usually low and your doctor may prescribe medication to control these side effects; Uterine rupture: Uterine rupture due to PGE1 can occur in women who have had uterine surgery. In addition, women who use PGE1 and Oxytocin to induce labor in the second trimester of pregnancy may also experience this condition. This risk is usually low and is something that your doctor will need to monitor very closely; Infection: Compared with prostaglandins, mechanical dilation such as laminaria may increase the risk of intrauterine infection. 5.2. Complications from Other Inducers of Labor Oxytocin: The use of oxytocin can cause intense contractions and be accompanied by signs that the fetus cannot tolerate these contractions. Violent uterine contractions can also occur, but are rare. This risk may be due to the dose of oxytocin. Other rare risks may include water intoxication and low blood pressure which may also occur at a low rate; Amniocentesis: The risk of amniocentesis (which breaks the water) can be umbilical cord prolapse (the umbilical cord prolapses outside the cervix). This complication often leads to a cesarean section. Other complications include chorioamnionitis (infection of the uterus and the linings of the placenta) and umbilical cord compression. Your doctor will closely monitor these complications; Amniocentesis: There is a risk of bleeding after amniotomy if placenta previa is not diagnosed before (because the placenta covers the opening in the cervix). Your doctor will perform an ultrasound before labor induction to confirm the position of the placenta. Hopefully, the above information has brought useful knowledge for pregnant women to make the most informed decision in the process of giving birth. All methods of labor induction have strict indications and contraindications. When performing these methods must be performed in medical facilities capable of surgery.
Vinmec International General Hospital offers a Package Maternity Care Program for pregnant women right from the first months of pregnancy with a full range of antenatal care visits, periodical 3D and 4D ultrasounds and routine tests to ensure that the mother is healthy and the fetus is developing comprehensively.
Pregnant women will be consulted and checked for health under the close supervision of experienced and specialized Obstetricians, helping mothers have more knowledge to protect their health during pregnancy as well as reduce reduce complications for mother and child.
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