Managing Complications in Pregnancy and Childbirth: - IAWG

Induction and augmentation of labourP-25• Do not use more than 50 mcg at a time and do not exceed fourdoses (200 mcg).Do not use oxytocin within 8 hours of using misoprostol.Monitor uterine contractions and fetal heart rate.FOLEY CATHETERThe Foley catheter is an effective alternative to prostaglandins forcervical ripening and labour induction. It should, however, be avoidedin women with obvious cervicitis or vaginitis.If there is a history of bleeding or ruptured membranes orobvious vaginal infection, do not use a Foley catheter.• Review for indications.• Gently insert a high-level disinfected speculum into the vagina.• Hold the catheter with a high-level disinfected forceps and gentlyintroduce it through the cervix. Ensure that the inflatable bulb ofthe catheter is beyond the internal os.• Inflate the bulb with 10 mL of water.• Coil the rest of the catheter and place in the vagina.• Leave the catheter inside until contractions begin, or for at least 12hours.• Deflate the bulb before removing the catheter and then proceedwith oxytocin.AUGMENTATION OF LABOUR WITH OXYTOCIN• Review for indications.• Infuse oxytocin as described for induction of labour (page P-19).Note: Do not use rapid escalation for augmentation of labour.