Managing Complications in Pregnancy and Childbirth: - IAWG

Induction and augmentation of labourP-19TABLE P-6Assessment of cervix for induction of labourRatingFactor 0 1 2 3Dilatation (cm) closed 1–2 3–4 more than 5Length of cervix (cm) more than 4 3–4 1–2 less than 1Consistency Firm Average Soft -Position Posterior Mid Anterior -Descent by station ofhead (cm from ischialspines)Descent by abdominalpalpation (fifths ofhead palpable)-3 -2 -1, 0 +1, +24/5 3/5 2/5 1/5OXYTOCINUse oxytocin with great caution as fetal distress can occur fromhyperstimulation and, rarely, uterine rupture can occur. Multiparouswomen are at higher risk for uterine rupture.Carefully observe women receiving oxytocin.The effective dose of oxytocin varies greatly between women.Cautiously administer oxytocin in IV fluids (dextrose or normal saline),gradually increasing the rate of infusion until good labour isestablished (three contractions in 10 minutes, each lasting more than 40seconds). Maintain this rate until delivery. The uterus should relaxbetween contractions.When oxytocin infusion results in a good labour pattern,maintain the same rate until delivery.• Monitor the woman’s pulse, blood pressure and contractions andcheck the fetal heart rate.