Induction

Induction labor is a procedure to stimulate uterine contraction during pregnancy before labor begins spontaneously. It is done for various reason, especially for mother and baby health reason. Elective induction may be accomplished by oxytocin infusion.

Advantages:

• IV oxytocin induction is usually successful when labor readiness has been established, fetal maturity is established and Bishop score is 9 or more.
• Maternal and fetal status can be monitored closely.

Disadvantages:
Induction is an invasive procedure.
Hypertonic labor, fetal distress, alterations in blood pressure, ruptured uterus.

Indications:

• Postmaturity
• Premature rupture of membranes
• PIH
• Presence of maternal disease such as diabetes mellitus
• Fetal demise.

Contraindications:

• Grand multiparity
• Placental abdominalities
• Previous uterine surgery
• Fetal distress
• Preterm fetus
• Positive CST
• Abnormal fetal presentation
• Presenting part above inlet
• Cephalopelvic disproportion (CPD).

Nursing Intervention:

• Obtain baseline tracing of uterine contractions
• Follow established protocols
• Increase IV dosage only after assessing contractions, FHR, and maternal blood pressure and pulse.
• Do not increase rate once desired contraction pattern is obtained.
• Discontinue oxytocin if contraction frequency is less than 2 minutes of duration is more than 90 seconds, or if fetal distress is noted.