Induction of labour at the start of the new millennium

Abstract

Around 20% of all deliveries are preceded by labour induction, a proportion that has not varied dramatically over recent years. Fetal death was the only indication for labour induction centuries ago, while this is now a very rare indication, with prolonged pregnancy and maternal hypertensive disorders being the major indications for the last 50-60 years. Techniques for inducing labour have also changed from dietary delicacies and verbal threats giving way to physical stimulation mainly achieved by cervical stretching and amniotomy and more recently to sophisticated pharmacological manipulation using oxytocin and prostaglandins, based on our expanding knowledge of the physiological processes involved in spontaneous parturition. Relaxin, antiprogestins, nitric oxide as well as complementary medicines have also been explored in recent years. Successful induction is, however, still not guaranteed and there has been increasing emphasis during the past decade on exploring strategies for identifying the probability of success. Measurement of fetal fibronectin in cervical mucus, maternal serum nitrite/nitrate concentrations, ultrasound delineation of cervical form and electrical impedance measurements across the cervix are all being investigated. Safety, success, and patient satisfaction continue to be the major objectives with economic evaluations now becoming a significant factor in the search for the ideal induction method.

Induction of Labor Prevalence and Associated Factors for Its Outcome at Wolliso St. Luke, Catholic Hospital, South West Shewa, Oromia

“…These indications may also either be evident or anticipated [3]. Rates of induction of labor vary from region to region.…”

Labor induction: comparison between oxytocin and dinoprostone

“…Prostaglandin E2 (PGE2) is an efficacious agent that shortens the time from induction to delivery, improves success rates, and reduces morbidity associated with labor induction. Although PGE2 may cause abnormal uterine contractions or FHR traces, abnormal psychomotor or physical development has not been reported in children born to mothers who received a vaginal PGE2 insert to stimulate cervical ripening (9). Vaginal PGE2 has been reported to provide a reasonable, effective, and reliable option to induce labor in an outpatient setting (10,11).…”

Hormonal imprinting in the central nervous system: causes and consequences

“…Központi idegrendszeri hatásának vizsgálata azért látszik különösen fontosnak, mert rendkívül gyakran alkalmazzák a szülés megindítására, az Egyesült Államokban például a szülések legalább 50, míg Nagy-Britanniában legalább 20%-ában [46,47], tehát széles körű közegészségügyi problémá-ról beszélhetünk.…”