Labour induction

Oxytocin is administered by slow intravenous infusion for labour induction. A27 D... 

Wing DA. A benefit-risk assessment of misoprostol for cervical ripening and labour induction. Drug Saf... 

Dinoprostone Prepidil Prostin E2 Pharmacia Upjohn Pharmacia Upjohn PGE2 Cervical ripening 500 fig in 2.5 ml (gel). Labour induction 1-2 mg per 2.5 ml (gel),0.5 mgh orally Termination of pregnancy 100 fig intra-amniotically, 5 fig ml IV... 

Misoprostol Arthotec Cytotec Searle Searle SC-29333 Anti-ulceration 800 fig orally Labour induction 25-50 /Jig vaginally... 

Lippert, T.H., and A.O. Mueck. 2002. Labour induction with alternative drugs J. Obstet. Gynaecol. 22(4) 343. 

Ritodrine relaxes the uterine muscle and is therefore indicated to prevent premature labour. Ergometrine, oxytocin and carboprost are all indicated to induce or augment labour by inducing uterine contractions and hence can be used to cause the uterus to contract after delivery. Dinoprostone is mostly used for the induction of labour. 

Induction of labour PG s do not have any advantage over oxytocin for the induction of labour. The adverse effects of the prostaglandins are slightly higher than that produced by oxytocin. PGF has more gastrointestinal toxicity than PGE and is a bronchoconstrictor also. Oral PGE is superior to oral oxytocin. PGE PGF is used in place of oxytocin in renal failure patients. 

Oxytocin is used in induction of labour, in postpartum haemorrhage, abortion and in breast engorgement. It is used by IM/IV route (PITOCIN, 2-5 lU/ml inj). 

It is also used as contragestational agent and for induction of labour. 

Geirsson RT. Uterine rupture following induction of labour with prostaglandin E2 pessaries, an oxytocin infusion and epidural analgesia. J Obstet Gynecol 1981 2 76. 

Thavarasah AS, Achanna KS. Uterine rupture with the use of Cervagem (prostaglandin El) for induction of labour on account of intrauterine death. Singapore Med J 1988 29(4) 351-2. 

Hofmeyr GJ, Gulmezoglu AM, Alfirevic Z. Misoprostol for induction of labour a systematic review. Br J Obstet Gynaecol 1999 106(8) 798-803. 

Hofmeyr GJ, Gulmezoglu AM. Vaginal misoprostol for cervical ripening and induction of labour. Cochrane Database Syst Rev 2003 (1) CD000941. 

Fletcher H, McCaw-Binns A. Rupture of the uterus with misoprostol (prostaglandin El) used for induction of labour. J Obstet Gynaecol 1998 18(2) 184-5. 

Oxytocin is used i.v. in the induction of labour and sometimes for uterine inertia, haemorrhage or during abortion. It produces, almost immediately rhythmic contractions with relaxation between, i.e. it mimics normal uterine activity... 

Ergometrine and oxytocin differ in their actions on the uterus. In moderate doses oxytocin produces slow generalised contractions with full relaxation in between ergometrine produces faster contractions superimposed on a tonic contraction. High doses of both substances produce sustained tonic contraction. It will be seen, therefore, that oxytocin is more suited to induction of labour and ergometrine to the prevention and treatment of postpartum haemorrhage, the incidence of which is reduced by its routine prophylactic use (generally i.m.). 

Embrey, M. Graham, N. McNeill, M. Induction of labour with a sustained-release prostaglandin E2 vaginal perssary. Br. Med. J. 1980, 281, 901-902. 

Kurup, A. Chua, S. Arulkumaran, S. Tham, K. Tay, D. Ratnam, S. Induction of labour in nulliparas with poor cervical score oxytocin or prostaglandin vaginal pessaries Austr. New Zealand J. Obstet. Gyn. 1991, 31, 223-226. 

Bugalho, A. Bique, C. Machungo, F. Bergstrom, S. A comparative study of vaginal misoprostol and intravenous oxytocin for induction of labour. Gyn. Obstet. Invest. 1995, 39, 252-256. 

The other main class of agent used for contractile actions on the uterus are the prostanoids. They may be used together with oxytocin for the induction of labour. Some are also used for therapeutic abortion e.g. gemeprost. See prostanoid RECEPTOR AGONISTS. 

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