Induction And Augmentation Of Labour

Oxytocin is administered by slow i.v. infusion as below, usually in conjunction with amniotomy, and dinoprostone by vaginal tablets, pressaries and vaginal gels. Misoprostol may be used orally or vaginally to induce labour (an unlicenced indication in the UK) The UK National Institute for Clinical Excellence has recommended that:

• dinoprostone is preferable to oxytocin for induction of labour in women with intact membranes, regardless of parity or cervical favourability;

• dinoprostone or oxytocin are equally effective for the induction of labour in women with ruptured membranes, regardless of parity or cervical favourability;

• intravaginal dinoprostone preparations are preferable to intracervical preparations;

• oxytocin should not be started for 6 hours following administration of vaginal prostaglandins; • when used to induce labour, the recommended dose of oxytocin by intravenous infusion20 is initially 0.001-0.002 units/minute increased at intervals of at least 30 minutes until a maximum of 3-4 contractions occur every 10 minutes (0.012 units/minute is often adequate); the maximum recommended rate is 0.032 units/minute (licensed max. 0.02 units/minute)

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