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3 - Induction of labour
- By Rebekah Samangaya, Specialist Registrar, Rochdale Hospital, Pennine Acute Hospitals, NHS Trust, Rochdale, UK
Alexander Heazell, University of Manchester, John Clift
Book:

Obstetrics for Anaesthetists

Published online:

21 August 2009

Print publication:

06 March 2008, pp 22-30
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Summary

The indications for induction of labour (IOL) can be divided into fetal or maternal indications. The IOL is initiated for a specific indication, due to the associated risks. Prolonged pregnancy is the most common indication for IOL. Guidelines from the National Institute for Health and Clinical Excellence (NICE) recommend offering IOL to women between 41 and 42 weeks gestation. The main risk for women with prolonged ruptured membranes is intra-uterine infection. Maternity units throughout the UK have different policies on timing of IOL and the location where induction is commenced. Intrauterine fetal death (IUFD) may occur at any stage of pregnancy. The causes of IUFD include fetal anomalies, infection, fetal hypoxia secondary to placental insufficiency. IUFD should be confirmed by two obstetricians or ultrasonographers, and is confirmed by visualisation of the inactive fetal heart. Women with IUFD have to deal with grief and labour pain.