What is the difference between labor induction and labor augmentation

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Previous Chapter. Next Chapter. Gary Cunningham, et al. Williams Obstetrics, Twenty-Fourth Edition. Cautiously administer oxytocin in IV fluids dextrose or normal saline , gradually increasing the rate of infusion until good labour is established three contractions in 10 minutes, each lasting more than 40 seconds.

Maintain this rate until delivery. The uterus should relax between contractions. When oxytocin infusion results in a good labour pattern, maintain the same rate until delivery. Review for indications. Be sure induction is indicated, as failed induction is usually followed by caesarean section.

Ensure that the woman is on her left side. Record the following observations on a partograph every 30 minutes : - rate of infusion of oxytocin see below ; Note : Changes in arm position may alter the flow rate; - duration and frequency of contractions; - fetal heart rate. Listen every 30 minutes, always immediately after a contraction. If the fetal heart rate is less than beats per minute, stop the infusion. Women receiving oxytocin should never be left alone.

Infuse oxytocin 2. This is approximately 2. Increase the infusion rate by 10 drops per minute every 30 minutes until a good contraction pattern is established contractions lasting more than 40 seconds and occurring three times in 10 minutes. Maintain this rate until delivery is completed. If there are not three contractions in 10 minutes , each lasting more than 40 seconds with the infusion rate at 60 drops per minute : - Increase the oxytocin concentration to 5 units in mL of dextrose or normal saline and adjust the infusion rate to 30 drops per minute 15 mIU per minute ; - Increase the infusion rate by 10 drops per minute every 30 minutes until a satisfactory contraction pattern is established or the maximum rate of 60 drops per minute is reached.

If labour still has not been established using the higher concentration of oxytocin: - In multigravida and in women with previous caesarean scars , induction has failed; deliver by caesarean section ; - In primigravida , infuse oxytocin at a higher concentration rapid escalation, Table P-8 : - Infuse oxytocin 10 units in mL dextrose or normal saline at 30 drops per minute; - Increase infusion rate by 10 drops per minute every 30 minutes until good contractions are established; - If good contractions are not established at 60 drops per minute 60 mIU per minute , deliver by caesarean section.

Do not use oxytocin 10 units in mL i. Record findings on a partograph. Prostaglandin E2 PGE2 is available in several forms 3 mg pessary or 2—3 mg gel. The prostaglandin is placed high in the posterior fornix of the vagina and may be repeated after 6 hours if required. Monitor uterine contractions and fetal heart rate of all women undergoing induction of labour with prostaglandins. This device may look like a long crochet hook or may be a smaller hook attached to the finger of a sterile glove.

The hook is used to pull gently on the amniotic sac until the sac breaks. This procedure is usually not painful. A large gush of fluid usually follows the rupture of the amniotic sac. The uterus continues to produce amniotic fluid until the baby's birth. So you may continue to feel some leaking, especially right after a hard contraction. If active labour has started on its own but contractions have slowed down or completely stopped, steps need to be taken to help labour progress augmentation.

Augmentation will be done when:. If labour fails to progress in spite of membrane sweeping, an amniotomy, oxytocin, or a combination of these measures, delivery by caesarean section may be considered. Author: Healthwise Staff. This information does not replace the advice of a doctor.

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Important Phone Numbers. Top of the page. Topic Overview Labour induction As the end of pregnancy nears, the cervix normally becomes soft ripe and begins to open dilate and thin efface , preparing for labour and delivery. Your labour may be induced for one of the following reasons: Your pregnancy has gone 1 to 2 weeks past the estimated due date. You have a condition such as high blood pressure , abruptio placenta , infection, lung disease, pre-eclampsia , or diabetes that may threaten your health or the health of your baby if the pregnancy continues.

Your baby has a condition that needs treatment, and the risks of vaginal delivery are low. Induction and vaginal delivery are not attempted if the baby may be harmed or is in immediate danger. Medical Review Policy All What to Expect content that addresses health or safety is medically reviewed by a team of vetted health professionals.

Leilani Rogers. Sometimes labor needs a little jump-start. Back to Top. In This Article. Continue Reading Below. Read This Next. Hospital Bag Checklist. View Sources. Mayo Clinic, Labor Induction , September