NOVEMBER 13, 2014

SOPHIA SORIANO-CASTILLO

INDICATIONS:

CONTRAINDICATIONS

COMPLICATIONS:

PROGNOSIS:

Hypertensive
complications of
pregnancy, fetal death,
chorioamnionitis, DM,
post term pgrenancy,
+ oligohydramnios, IUGR,
PROM w/ fetal maturity

Acute, severe fetal

distress, transverse lie,
floating fetal presenting,
uncontrolled
hemorrhage, placenta
previa, previous uterine
incision, NRFHT

C-section from noncontracting and

prolonged labor.

Labor induction or
augmentation lowers the
risk of having a Csection d/t prolonged
labor (Gerli et al, 2013).

LABOR INDUCTION &

AUGMENTATION
FACTORS INFLUENCING INDUCTION
Prolonged pregnancy with 1 or 2 weeks
overdue.
High risk pregnancies such as
preeclampsia, GDM, placenta abrupt,
infection or lung disease.
Water bag (amniotic sac) has been broken
without initiation of contraction.
Baby has medical concerns that needs
medical attention right away. May do so
with low risk vaginal delivery.
Distance from home and hospital.
Induction may be done as early as 39
weeks of GA.

FACTORS INFLUENCING AUGMENTATION

When active labor or contraction has stopped

from progressing. Medication will be needed
to further the process of softening, effacing
and dilating the cervix.
TO START INDUCTION:
Balloon catheter
Sweeping the membrane
Rupture the amniotic sac
Medicine (see Augmentation Intervention)

AUGMENTATION & ADVERSE EFFECTS:

MISOPROSTOL (CYTOTEC)
HA, abd. pain, diarrhea, monitor for bleeding
Avoid aluminum hydroxide & Mg w/ antacids
OXYTOCIN (PITOCIN)
Fetalhypoxia, uteroplacental insufficiency
Maternaluterine tachysystole, placenta abruptio,
pph, uterine rupture, infection & death
DINOPROSTONE (CERVIDIL OR PREPIDIL GEL):
HA, N/V, diarrhea, fever, hypotension, fetal passage
of meconium
Avoid use in o+ w/ asthma, glaucoma, HTN or

NURSING INTERVENTION:
During augmentation, provide periodic
vaginal exam to assess softening,
effacement & dilation of cervix.
Monitor for FHR, frequency and durations of
contractions on FHR monitor.
If using balloon catheter, monitor for balloon
to drop at approximately 3 cm dilation.
Teach the difference of sweeping or
rupturing membrane. Sweeping is less risk
for infection, but does not work for all
women. Rupturing membrane poses high
risk for infection.
Report to HCP if contraction has stopped
while on augmentation.
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NOVEMBER 13, 2014

SOPHIA SORIANO-CASTILLO

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