Induction of labour: conclusions

332 voor Obstetrie and Gynaecologie and de Niederrheinisch-Westfahsche Gesellschaft fur Gynilkologie und Geburtshilfe, Bruges, 6th June 1980. 3. Taylor ES. Editorial comment. Obstet Gynecol Surv 1981; 188. 4. Kubli F. Results of the intensive perinatal management of very-low-birthweight infants (501-1500 pm). Discussion. In: Anderson A, Beard RW, Brudenell JM, Dunn PM, eds. Pre-Term Labour, London: Royal College of Obstetricians and Gynaecologists, 1977: 356-360. 5. Lin C-C, Moawad AH, Rosenow PJ, River P. Acid-base characteristics of fetuses with intrauterine growth retardation during labour and delivery. J. Obstet Gynecol 1980; 137: 553-559. 6. Amy JJ, Thiery M. Labor - spontaneous and induced. In: Aladjem S, Brown AK, Sureau C, eds. Clinical Perinatology, 2nd ed. St. Louis, Mosby, 1980: 362-381. 7. Esteban-Ahirriba J. The use of beta-adrenergics in fetal distress. Europ J Obstet Gynaec Reprod Biol, 1983. 8. Crawford JS, Weaver JB, Wilday RJ. Obstetric Clinical Care. Amsterdam, Elsevier/North Holland, 1980. 9. Jouppila P, Jouppila R, Hollmen A, Koivula A. Lumbar epidural analgesia to improve intervillous blood flow during labor in severe preeclampsia. Obstet Gynec 1982; 59: 158- 161. induction of labour: conclusions J.J. Amy As in many aspects of perinataf medicine, considerable progress has been accomplished over the last 15 yr in the field of induction of labour. Provided a correct technique is used, and feto-pelvic disproportion or acute fetal distress are not encountered, the overwhelming majority of women induced are delivered vaginally. The most important contribution in this regard is unquestionably the introduction of prostaglandins into clinical obstetrics [ 11. Prostaglandins are intimately involved in the physiological processes of cervical ripening and parturition. Given in pharmacological doses, they have proven markedly more effective than oxytocin for the induction of labour in gravidae with poor inducibility features. The next giant step made was the application of prostaglandins locally to effect artificial ripening of the cervix, prior to induction [2]. At present, a variety of techniques, the safety of which has been demonstrated by Thiery and collaborators, is available which allows the obstetrician to tailor the induction of labour to the particular needs of the individual patient [3,4]. Induction has become a whole new thing. Gentle. And efficacious. References 1. Karim SMM, Trussell RR, Pate1 RC, Hillier K. Response of pregnant human uterus to prostaglandin F, induction of labour. Brit Med J 1968; 4: 621-623. 2. Calder AA, Embrey MP, Tait T. Ripening of the cervix with extra-amniotic prostaglandin E, in viscous gel before induction of labour. Brit J Obstet Gynaec 1977; 84: 264-268. 3. Thiery M, Amy JJ. Perinatal effects of natural prostaglandins used for labor induction. In: Coceani F, Olley PM, eds. Prostaglandins and Perinatal Medicine. New York: Raven Press, 1979: 307-324. 4. Amy JJ, Thiery M. Labor -spontaneous and induced. In: Aladjem S, Brown AK, Sureau C, eds. Clinical Perinatology, 2nd ed. St. Louis: Mosby; 1980: 362-381

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Transcript of Induction of labour: conclusions

Page 1: Induction of labour: conclusions

332

voor Obstetrie and Gynaecologie and de Niederrheinisch-Westfahsche Gesellschaft fur Gynilkologie und Geburtshilfe, Bruges, 6th June 1980.

3. Taylor ES. Editorial comment. Obstet Gynecol Surv 1981; 188. 4. Kubli F. Results of the intensive perinatal management of very-low-birthweight infants (501-1500

pm). Discussion. In: Anderson A, Beard RW, Brudenell JM, Dunn PM, eds. Pre-Term Labour, London: Royal College of Obstetricians and Gynaecologists, 1977: 356-360.

5. Lin C-C, Moawad AH, Rosenow PJ, River P. Acid-base characteristics of fetuses with intrauterine growth retardation during labour and delivery. J. Obstet Gynecol 1980; 137: 553-559.

6. Amy JJ, Thiery M. Labor - spontaneous and induced. In: Aladjem S, Brown AK, Sureau C, eds. Clinical Perinatology, 2nd ed. St. Louis, Mosby, 1980: 362-381.

7. Esteban-Ahirriba J. The use of beta-adrenergics in fetal distress. Europ J Obstet Gynaec Reprod Biol, 1983.

8. Crawford JS, Weaver JB, Wilday RJ. Obstetric Clinical Care. Amsterdam, Elsevier/North Holland, 1980.

9. Jouppila P, Jouppila R, Hollmen A, Koivula A. Lumbar epidural analgesia to improve intervillous blood flow during labor in severe preeclampsia. Obstet Gynec 1982; 59: 158- 161.

induction of labour: conclusions

J.J. Amy

As in many aspects of perinataf medicine, considerable progress has been accomplished over the last 15 yr in the field of induction of labour. Provided a correct technique is used, and feto-pelvic disproportion or acute fetal distress are not encountered, the overwhelming majority of women induced are delivered vaginally.

The most important contribution in this regard is unquestionably the introduction of prostaglandins into clinical obstetrics [ 11. Prostaglandins are intimately involved in the physiological processes of cervical ripening and parturition. Given in pharmacological doses, they have proven markedly more effective than oxytocin for the induction of labour in gravidae with poor inducibility features. The next giant step made was the application of prostaglandins locally to effect artificial ripening of the cervix, prior to induction [2].

At present, a variety of techniques, the safety of which has been demonstrated by Thiery and collaborators, is available which allows the obstetrician to tailor the induction of labour to the particular needs of the individual patient [3,4]. Induction has become a whole new thing. Gentle. And efficacious.

References 1. Karim SMM, Trussell RR, Pate1 RC, Hillier K. Response of pregnant human uterus to prostaglandin

F, induction of labour. Brit Med J 1968; 4: 621-623. 2. Calder AA, Embrey MP, Tait T. Ripening of the cervix with extra-amniotic prostaglandin E, in

viscous gel before induction of labour. Brit J Obstet Gynaec 1977; 84: 264-268. 3. Thiery M, Amy JJ. Perinatal effects of natural prostaglandins used for labor induction. In: Coceani F,

Olley PM, eds. Prostaglandins and Perinatal Medicine. New York: Raven Press, 1979: 307-324. 4. Amy JJ, Thiery M. Labor -spontaneous and induced. In: Aladjem S, Brown AK, Sureau C, eds.

Clinical Perinatology, 2nd ed. St. Louis: Mosby; 1980: 362-381