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Labor induction is the process or treatment that stimulates childbirth and delivery. Inducing (starting) labor can be accomplished with pharmaceutical or non-pharmaceutical methods. In Western countries, it is estimated that one-quarter of pregnant women have their labor medically induced with drug treatment. [1]
The natural ripening of the cervix is mediated by prostaglandins, thus a common pharmacological method is to use external prostaglandins such as PGE 2, or dinoprostone. [3] Results of a systematic review and meta-analysis of the literature found that outpatient cervical ripening with dinoprostone or single-balloon catheters did not increase the ...
Histologically, the cervix undergoes significant changes towards the end of gestation, allowing the ripening of cervix for the passage of birth delivery. First, there is an increase in the cervical synthesis of glycosaminoglycan hyaluronan (HA), which increases tissue hydration, thereby catalyzing the degradation of collagen and elastin-fibers.
Effacement translates to how 'thin' the cervix is. The cervix is normally approximately three centimetres long, as it prepares for labour and labour continues the cervix will efface until it is 'fully effaced' (paper-thin). Cervical dilation: Closed 1–2 cm 3–4 cm 5+cm Dilation is a measure of how open the cervical os is.
Cervical ripening is the physical and chemical changes in the cervix to prepare it for the stretching that will take place as the fetus moves out of the uterus and into the birth canal. A scoring system called a Bishop score can be used to judge the degree of cervical ripening to predict the timing of labour and delivery of the infant or for ...
Rankins says cervical insufficiency happens when there's painless dilation, or opening, of the cervix, typically in the second trimester of pregnancy, or during weeks 13 through 28.
Cervical dilation may be induced mechanically by placing devices inside the cervix that will expand while in place. A balloon catheter may be used. Other products include osmotic dilators , such as laminaria stick (made of dried seaweed) or synthetic hygroscopic materials, which expand when placed in a moist environment.
Misoprostol can be used to induce labor in patients at the end of pregnancy. It causes cervical ripening, or the thinning and shortening of the cervix in preparation for birth. It also causes uterine contractions, allowing the body to expel the baby. For this purpose, it is placed inside the vagina. [8] [15]