Induction of Labour

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???????????????
???????????? ????????
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??????????????? ( Induction of Labour
) ???????? ?????????????????????????????????????
??????????????????????????????????????????????????
?????????????????????
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• ???????
• ????????? ( Placenta Previa )
• ???????????
• ??????????????????????????????????????????????
• Funic presentation or Prolapse cord
• Hx. C / S

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• Full thickess myomectomy
• ?????????????????????????????????
• ?????????????????????????? Active
• Acute fetal distress ?????????
• ????????????????????? ??????????????????????????
  ?

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• ?????????????????????????????????????????
• ?????????
• ???????????????????????????????????
• ?????????????????????????????????????
• - ??????????? lt 3 ?????? Unfavorable
• - ???????? 3 7 ???????????????????????
• - ????? gt 7 ?????? Favorable

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Bishop pelvic scoring system
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???????????????????????????? ???????? 2 ????
??? 1. Surgical induction of labour 2.
Medical induction of labour
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• Surgical induction of labour
• ???????????????????????????
• 1.1 ???????????????????? ( Membrane Stripping
  )
• ?????????????????????????????????????
  (Chorionic membrane ) ?????????????? ???
  decidua ????????????????

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1.2 ????????????????? ( Amniotomy or
Artificial rupture of membrane )
??????????????????????????????????????????????????
??????????????????? ????????????????????????????
???????? prostaglandin ???????????????????? 15
???? ????????????????
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????????? 1. ???????????????? ?????? Allis
forcep, bed pan 2. ????????????? ??????? ,
????? 3. ??? FHS ????????? Record 4.
Record ?? , ????? ??? Amniotic fluid 5. ???
FHS ?????????????????? 6. ???????????? ????????
??????????????????????????????????
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• ??????????? ????????????????
• 8. ?????? uterine contraction Progess
  of labour
• 9. ???????????????? ?????? ???????? ??????????
• v/s ??? 4 hrs. ????????????????????????????
  ?????? Antibiotic drugs
• 11. ????????????????????????????
  ???????????????????????????????

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• ????????????
• Prolapse of cord
• Infection
• Drylabour
• ????????????????
• Amniotic ebolism

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• Medical Induction of labour
• 2.1 Oxytocin
• ???????????
• ?????? 5 D /N /2 1,000 cc. Syntocinon
  10 unit
• 1,000 cc. ?? Syntocinon 10,000
  milliunit
• 1 cc. ?? Syntocinon 10,000
  10 ml.u

1,000
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• ??? ( 1 cc. ) ?? 10
  milliunit
• 3 ??? ??
  10 x 3
• 2 milliunit

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?????????????????????? ?????????? ???? ???
15 ???? ?????? 30, 40 , 60 ???? ?????
??????????? pain ?????????????
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2. ??? Hypertonus ( contraction gt 90
sec. ) ???? tachysystole ( contraction gt 6
????? / 10 min ) ????????????????? -
????????????????? - ?????? contraction -
FHS - ???????? ??? Bricanyl 0.25 mg.
v
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3. ?????? Oxytocin ??? 4 6 ?????
contraction ????????? 4. ???????????????
Oxytocin ?????????? 20 ml.u ???? ????
10 unit ??? 2 ml. u ??
3 ??? 20 ml. u ??
3 X 20 30 ???
2
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• ??????????????????
• ?? Hx. ??????? ,???????????????? Induction ,
  Hx. ??????????????????????????????????????????
• ??????????????????
• ??? FHS, ??? Contraction ????????? 20 min.
• ??? Interval lt 2 min. Or Duration gt 60
  sec.

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????????????????? - ????????? -
?????????????????????? - ??????????? 6 - 8
????/???? 5. ??????????? 6. ?????????????? ???
15 - 30 ????
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7. ??? FHS ?? 30 ??????? ??? 5 ????
??????????? ?????? 15 ???? 8. V / S
???????? 9. ???????????? 10.
????????????????????????
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2.2 Prostaglandin ?????????????????????????????
???????? Cx. ?????????????????? ????????????????
????? Induction ??????? Prostaglandin E 2 (
PGE 2 ) ???? Cytotec
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??????? ???????????????????? Posterior
fonix ?????????????????????????????????
intracervical ???????????? 1. V / S ??? 15
- 30 ?????? 1 ?????????? ??? 1
??. ???????? 4 ??. 2. Contraction FHS
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3. ??? contraction ?? ( Interval 2 3
min. ??? Duration 45 60 sec. ) 4. ??????
Oxytocin ???????????? Prostaglandin ?????? 12
hrs. 5. ?????? PV ????? ?????????????
????????????
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THE END