Failed Induction of Labour

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Definition

-  Failure of IOL = >12 hrs of oxytocin after rupture of membranes (ARM or SROM) without progression from latent phase of 1st stage of labour to active phase

-  On VE <4cm w 80% effacement OR <5cm regardless of effacement

 

Features

-  70% women enter active phase by 6hrs of oxytocin from rupture of membranes

-  <5% pts remain in active phase after 12hrs oxytocin

-  Longer latent phase ass w increased incidence of chorioamnionitis, endometritis & uterine atony

-  Women w intact membranes at IOL avg 3hrs oxytocin prior to SROM & 16.5hrs to delivery

-  Women w ruptured membranes at IOL avg 15.5hrs to delivery

-  No increase in neonatal morbidity

 

Mx

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References

 

Failed Labour Induction, Ronse et al, Journal of Obstetrics & Gynaecology; Vol 117, Feb 2011