What does induced labor mean? Experts explain

Induced labor is a way for women to end pregnancy. It is also used for people who can no longer undergo abortion surgery after the period of artificial abortion. Or it is a surgery performed when the fetus is found to have abnormalities or deformities.

What is Induction of Labor?

Induced labor refers to the use of artificial methods to induce uterine contractions to end pregnancy after 12 weeks of pregnancy due to maternal or fetal reasons. According to the gestational age at the time of induced labor, it can be divided into mid-term induced labor (14 to 28 weeks) and late-term induced labor (after 28 weeks).

Methods of inducing labor

The ideal method of promoting cervical ripening is similar to its natural ripening process, will not cause excessive uterine contraction, will not affect uterine blood flow, and will not endanger the safety of the fetus and mother. There are many ways to promote cervical ripening, but there is still no perfect and effective method. Currently, the commonly used methods are divided into two categories: non-drug and drug:

1. Non-drug methods: ① Artificial membrane stripping (basically not used); ② Artificial membrane rupture (not effective when used alone); ③ Water bag or Foley catheter (not routinely used); ④ Hygroscopic dilator or Lamicel rod (rarely used); ⑤ Nipple stimulation (not often used); ⑥ Acupuncture therapy (basically not used).

2. Drug therapy: ① Oxytocin, small dose and low concentration intravenous drip; ② Prostaglandin PGE2 (commonly used); ③ PGE2 gel intracervical administration (rarely used); ④ PGE2 vaginal controlled release tablets - Probeson (commonly used); ⑤ Misoprostol (not routinely used); ⑥ Vaginal placement of misoprostol; ⑦ Carboprostol suppository (basically not used); ⑧ Mifepristone (not used for late induction of labor).

Preparation for induction of labor

The success of induced labor is related to various factors. Cervical maturity is an important factor in determining the success of induction of labor. If the cervix is ​​immature, induction of labor is often not successful. Most women with a mature cervix can give birth vaginally.

1. Cervical scoring In 1964, Bishop developed a scoring system to determine whether a pregnant woman is suitable for elective induction of labor. The currently recognized method for estimating cervical maturity is the Bishop score. He believes that a score ≥ 7 indicates that the cervix is ​​mature. The higher the score, the more mature the cervix, and the easier it is to successfully induce labor. If the score is below 6, cervical ripening should be promoted.

2. Methods to promote cervical ripening The cervix is ​​mainly composed of epithelium, smooth muscle, connective tissue, glands and matrix. Cervical maturity is not necessarily proportional to gestational age, but is related to the biological changes in cervical tissue. After pregnancy, the cervical tissue undergoes changes, which become more obvious as the pregnancy progresses and reach a peak during delivery. Typical manifestations are: a significant decrease in collagen fibers, which become loose and reticular; blood vessels become dilated and congested; white blood cells accumulate and adhere to the wall, and a large number of white blood cells and fibroblasts appear in the interstitium. Cervical ripening may be the result of the action of multiple hormones, such as estrogen, progesterone, relaxin and prostaglandins.