Trends/Controversies in Labor Induction: Cook

Question 1

What is the most common drug used for the induction of labor?
What are its side effects/limitations?

Answer 1

Oxytocin (Pitocin)
Can cause overstimulation of the myometrium leading to exhaustion of the muscle and inability to control postpartum hemorrhage.
Antidiuretic effect can also cause water intoxication and hyponatremia.

Question 2

What is considered the most important indicator in the success of labor induction?

Answer 2

Cervical ripening

Question 3

How do prostaglandins induce labor?

Answer 3

Block progesterone (maintains pregnancy) and cause a local inflammatory response. Synthetic PGE2 also causes cervical ripening. 
Soften cervix.

Question 4

List the 3 prostaglandin preparations in use to soften the cervix.
What are their limitations to use with oxytocin?

Answer 4

Dinoprostone
Carboprost tromethamine
Misoprostol- most rapid action

Limitations:
::Don’t use them when using oxytocin. Wait 6 hrs before using oxytocin.
::Not recommended for use when mom has uterine scars from previous cesarean birth.