Labor Induction before Caesarian Delivery

Michael Cameron^*

Department of Gynecology, School of Medical Science, Harvard University, USA

Abstract

Obstetricians often have to decide between performing an induction of labor and performing a repeat cesarean section for women who have had previous cesarean deliveries because of the historically high rates of cesarean delivery in the United States. During clinical evaluation of this scenario, it is necessary to weigh the advantages of a successful labor trial following a cesarean section against the dangers of symptomatic uterine rupture. This article will discuss the uncommon but clinically significant situation of labor induction following a cesarean birth, including the method of induction and induction in the context of stillbirth and fetal anomalies in the second trimester.

Keywords

Labor cesarean delivery • Uterine rupture • Still birth

Introduction

Obstetricians often have to choose between performing an induction of labor and performing a repeat cesarean section for women who have had previous cesarean deliveries because of the historically high rates of cesarean delivery in the United States. Clinical assessment of this situation includes gauging the advantages of a fruitful preliminary of work later cesarean conveyance (TOLAC) against the dangers related with indicative uterine burst. These dangers include: bonding, hysterectomy, fetal hypoxic ischemic encephalopathy, and fetal death. The focal point of this audit is to investigate these dangers related with every technique for acceptance as well as to help suppliers arrange the probability of fruitful vaginal conveyance. In addition, the uncommon but clinically significant situation of labor induction following a cesarean delivery in the second trimester in the face of stillbirth or fetal anomalies will be discussed in this article [1, 2].

Enlistment of work without cervical aging

Current guidelines from multiple obstetrical societies generally allow for the use of labor induction for both maternal and fetal reasons. When considering labor induction, one needs to think about how it might affect the rate of uterine rupture and the likelihood of vaginal delivery. The decreased success of vaginal birth associated with induction of labor must be discussed with women considering it. The majority of trials compare women who are induced to those who enter spontaneous labor, so some authors have suggested that the risk of induction may be exaggerated. Retrospective studies consistently demonstrate a higher rate of cesarean delivery following induction of labor. The fact of the matter is that the comparison groups are not appropriate because many women who may be planning a spontaneous birth will medically require an induction. There has been no evidence of an increase in the rate of cesarean delivery in the few randomized trials comparing expectant versus labor induction [3].

Using Pictosin

Women who have had a previous cesarean section and are undergoing induction of labor face similar concerns. A few studies exhibit an expanded gamble of uterine break in ladies going through enlistment of work. In a MFMUpublished retrospective cohort study of 17,898 women, Pitocin-induced labor was associated with a 2.86 fold (95% CI: 1.754.67) rise in the chance of the uterus breaking. Despite this, a low overall risk of 1.1% was noted. Pitocin induced labor was associated with a 4.6-fold risk of uterine rupture in a smaller Zelop study involving 2774 women. In contrast, a review distributed by Lydon-Rochelle, who test ined the Washington State Birth Occasions Record Information base, tracked down no expanded gamble of uterine burst among 20,095 ladies whose works started with a Pitocin enlistment. Similar to Ravasia’s findings, Ravasia’s cohort of 21,119 women who underwent a trial of labor after cesarean delivery did not see an increase in the rate of uterine rupture. Whether or not it is utilized for enlistment or expansion, it is intriguing to take note of that Cahill et al. found a doseresponse impact in ladies who got Pitocin during a TOLAC [4, 5].

Induction with prostaglandin

Prostaglandins have historically been discouraged from being used as cervical ripening agents in women who have had previous cesarean sections. The proof deterring this training begins from a little clinical preliminary in which 2 of 17 ladies getting misoprostol experienced uterine crack. A study that Lydon-Rochelle published echoed this concern. The relative risk of uterine rupture in the 1960 women who received prostaglandins for labor induction was found to be 15.6 (95% CI: 8.130.0, patients with no work 1.0). Comparatively, in an article looking at ladies endeavoring TOLAC by acceptance of work with prostaglandins versus ladies encountering unconstrained beginning of work, ladies who were given prostaglandins encountered an expanded chance of uterine burst. Prostaglandins should not be given to patients who have had a cesarean section in the past because of this consistent data [6, 7].

Induction of labor other than cervical ripening

Current guidelines from multiple obstetrical societies generally allow for the use of labor induction for both maternal and fetal reasons. When considering labor induction, one needs to think about how it might affect the rate of uterine rupture and the likelihood of vaginal delivery. The decreased success of vaginal birth associated with induction of labor must be discussed with women considering it. The majority of trials compare women who are induced to those who enter spontaneous labor, so some authors have suggested that the risk of induction may be exaggerated. Retrospective studies consistently demonstrate a higher rate of cesarean delivery following induction of labor [8]. The fact of the matter is that the comparison groups are not appropriate because many women who may be planning a spontaneous birth will medically require an induction. There has been no evidence of an increase in the rate of cesarean delivery in the few randomized trials comparing expectant versus labor induction [9, 10].

Conclusion

Providers must weigh the likelihood of a successful vaginal delivery against the risk of uterine rupture when deciding whether or not to induce labor in women who have previously undergone a cesarean section. There is convincing evidence that prostaglandins should not be used unless there is a stillbirth or genetic termination during the second trimester. Pitocin induction and augmentation both have the potential to raise the risk of uterine rupture, but they should be carefully considered as part of clinical labor management. Restricted information of involving the Foley bulb for work enlistment exists, yet, it might offer a more secure other option.

References

1. Grobman WA, Gilbert S, Landon MB. Outcomes of induction of labor after one prior cesarean. Obstet Gynecol. 109, 262-269 (2007).

Indexed at, Google Scholar, Crossref  

2.  Zelop CM1, Shipp TD, Repke JT et al. Uterine rupture during induced or augmented labor in gravid women with  one  prior cesarean delivery. Am J Obstet Gynecol. 18, 882-886 (1999).

Indexed at, Google Scholar, Crossref  

3. Ravasia DJ, Wood SL, Pollard JK. Uterine rupture during induced trial of labor among women with previous cesarean delivery. Am J Obstet Gynecol. 183, 1176-1179 (2000).

Indexed at, Google Scholar, Crossref

4. Cahill AG, Stamilio DM, Odibo AO et al. Does a maximum dose of oxytocin affect risk for uterine rupture in candidates for vaginal birth aftercesarean delivery? Am J Obstet Gynecol. 197, 495.e1– 495.e5 (2007).

Indexed at, Google Scholar, Crossref

5. Wing DA, Lovett K, Paul RH. Disruption of prior uterine incision following misoprostol for labor induction in women with previous cesarean delivery. Obstet Gynecol. 91, 828–30 (1998).

Indexed at, Google Scholar, Crossref

6.  Lydon Rochelle M, Holt VL, Easterling TR et al. Risk of uterine rupture during labor among women with a prior cesarean delivery. N Engl J Med. 345, 3-8 (2001).

Indexed at, Google Scholar, Crossref

7. Kwee A, Bots ML, Visser GHA et al. Obstetric management and outcome of pregnancy in women with a history of caesarean section in the Netherlands. Eur J Obstet Gynecol Reprod Biol. 132, 171-176 (2007).

 Indexed at, Google Scholar, Crossref

8. Bujold E, Blackwell SC, Gauthier RJ. Cervical ripening with transcervical foley catheter and the risk of uterine rupture. Obstet Gynecol. 103, 18-23 (2004).

Indexed at, Google Scholar, Crossref

9. Jozwiak M, Van de Lest HA, Burger NB et al. Cervical ripening with Foley catheter for induction of labor after cesarean section: a cohort study. Acta Obstet Gynecol Scand. 93, 296-301(2014).

Indexed at, Google Scholar, Crossref

10. Ben Aroya Z, Hallak M, Segal D et al. Ripening of the uterine cervix in a post-cesarean parturient: prostaglandin E2 versus Foley catheter. J Matern Fetal Neonat Med. 12, 42-45 (2002).

Indexed at, Google Scholar, Crossref