What are the steps to induce labor?

Sometimes, due to the fetus or the mother's body, induced labor may be needed, but many female friends are not clear about the steps of induced labor, so that they can prepare themselves mentally. Next, let the authoritative experts explain in detail the steps of induced labor.

Induction of labor includes water bag induction, trichosanthes induction, rivanol induction, genkwater induction, and prostaglandin induction.

After 16 weeks of pregnancy, due to the above-mentioned physiological characteristics, the method of termination of pregnancy is completely different from that of early pregnancy, and is similar to induction of labor during full-term pregnancy. Regular uterine contractions must be induced to promote the disappearance of the cervical canal and the dilation of the cervix. In mid-term pregnancy, it is more difficult to initiate uterine contractions than in full-term pregnancy, and the conditions for cervical dilation are also poor. The pregnancy must be terminated through the following methods:

1. Drugs stimulate uterine contractions. During a normal pregnancy, the progesterone and prostaglandins in the body are in a balanced state, and are not likely to induce uterine contractions. Especially in the second trimester of pregnancy, the balance is more stable, and even the use of general uterine contraction drugs such as oxytocin is difficult to induce effective uterine contractions. Exogenous drugs enhance the dominance of prostaglandins, disrupt this balance, and can cause rhythmic uterine contractions and lead to miscarriage. Exogenous prostaglandins for induction of labor and the increase in endogenous prostaglandins caused by genkwa and rivanol for induction of labor both belong to this type of effect.

2. Drugs reduce the secretion of placental hormones. The drugs used act directly on the trophoblast cells, causing them to degenerate and denature, thereby reducing placental function and the secretion of chorionic gonadotropin and progesterone. After progesterone is inactivated, the inhibition of prostaglandins in the body is released, leading to miscarriage. Radix Trichosanthis, Rivanol and hypertonic saline can all cause necrosis of trophoblast cells.

3. Mechanical stimulation of uterine contraction. It involves a dramatic increase in uterine volume and mechanical stimulation of the cervical canal to induce reflex contractions. The former is when hypertonic saline or other hypertonic solutions are injected into the amniotic cavity to cause a sudden increase in the amount of amniotic fluid. Placing a water bag in the uterus increases intrauterine pressure while also stimulating the cervical canal. Gelatin sticks, bougies, and intrauterine catheters are all mechanical stimulations of uterine contractions.

4. Surgical removal of the fetus. Including abdominal and vaginal cesarean section and forceps curettage.

There are two main methods of inducing labor in the second trimester:

One major category is the induction method of water bag plus oxytocin; the other major category is drug induction, such as levanol induction, trichosanthes induction, hypertonic saline replacement, terpenoid membrane induction, gansuigongchong, prostaglandin induction, diluted alcohol induction, etc.

As for the various methods of inducing labor in mid-term pregnancy, according to the actual conditions in China, combined with the consideration of simple methods, short abortion time, small amount of medicine, good effect, mild side effects, few complications, wide source of medicine and economic factors, the commonly used methods in my country are water bag plus oxytocin induction and levanol induction, which are introduced as follows:

Water bag induction of labor is suitable for those who wish to terminate the pregnancy at 16 to 24 weeks of pregnancy. However, it is not suitable for those with uterine scars, inflammation of the reproductive organs, acute stage of heart, liver, and kidney diseases, and repeated vaginal bleeding during pregnancy. Anyone who requires induced labor with a water bag should be admitted to the hospital after passing the outpatient examination. Before inserting the water bag, the vaginal cleanliness is required to be qualified (1st degree), and the vagina can be flushed for 3 days first. Be sure to use sterile techniques when inserting the water bag. The water bag is made of a double-layer condom, which is first boiled and sterilized and then placed into the uterine cavity. Depending on the stage of pregnancy, the doctor will determine the amount of sterile saline solution to be injected into the sac. After injection, tie the end of the water bag tightly with silk thread, wrap it with a piece of gauze, and place it in the vagina. The water bag and gauze were removed the next day, and a small amount of oxytocin was given intravenously to stimulate uterine contraction. At this time, a dedicated person (doctor or nurse) should carefully observe the blood pressure, pulse, uterine contraction, abdominal pain, and other induced labor conditions and other special circumstances. If you find that the uterus contracts too strongly or the cervix is ​​not open, you should take timely measures. After the cervix is ​​dilated and the fetus and placenta are delivered, check the birth canal for any lacerations. If so, suture them immediately. Check the integrity of the placenta and fetal membranes. If not, perform a curettage immediately. Then give antibiotics, uterotonics and lactation-reducing drugs. Therefore, water bag induced labor must be performed in hospital.

Pregnant women who use Levanol to induce labor must undergo outpatient examinations and be admitted to the hospital after passing the examination. A levonol allergy test is required before induction of labor. Use 5-10 ml of 1:5000 levanol, put it into an eye drop bottle, drop 2 drops into the eye, and observe the results after 20 minutes; you can also use 0.1 ml of 1:4000 levanol for intradermal testing. If there is limited conjunctival or nasal mucosal congestion, edema, nasal congestion, palpitations, migraine, rash, etc., it means that the person is allergic to levanol and this method of inducing labor should not be used; if the result is negative, it can be performed. In addition, pregnant women should clean their skin, shave their hair, and empty their bladder before inducing labor. After skin disinfection, 100 ml of sterile levanol solution is injected into the amniotic cavity through the lower abdomen to stimulate uterine contraction, turning irregular contractions of the uterus into regular contractions, and slowly widening the cervix to draw the fetus out. This is a safe and reliable method of inducing labor with a high success rate. The disadvantage of this method is that a small number of pregnant women will have fever during induced labor, which generally does not exceed 38°C, but can quickly return to normal after antibiotic treatment. Another disadvantage is the residual decidua, so that most pregnant women need to undergo uterine curettage after induced labor.

The above is the relevant article about the steps of induction of labor. I hope that after reading the above article, you can have a comprehensive understanding of the steps of induction of labor. After choosing induction of labor, you must take good care of your body, which can also prevent some diseases.