Abstract

Introduction

Induction of labour is the deliberate initiation of labour before spontaneous onset anytime after the period of viability with the aim of delivery per vagina as a matter of urgency either for the foetus or the mother or both.  Although smooth muscle contracts when stretched but in pregnancy effective uterine contractions do not begin before term. It is the alteration of the oestrogen- progesterone ratio with appearance of prostaglandins synthesis and building up of oxytocin receptors in the myometrium, decidua’s and placenta. Oxytocin release in spurts from maternal neurohypophysis, acts on the sensitized myometrium and starts the uterine contraction. At the same time the foetal pituitary starts secreting both oxytocin and vasopressin, either as a result of stress or because of a genetically controlled trigger mechanism.). The PGE₂ acts mainly in the cervix to enhance uterine contraction and PGI₂ protects the vascular endothelium thus ensuring uterine blood flow and proper oxygenation to the foetus during forceful uterine contraction. The increase myometrial contraction leads to rupture of membrane, which in turn augments the production of prostaglandins that help in the final expulsion of the foetus through the fully effaced and dilated cervix.

Aims and Objective

My aim is to study the induction of labour by prostaglandin PGE₁ (misoprostol intravaginal), PGE₂ (intracervical dinoprostone) & oxytocin infusion separately and to compare among them with

1. Mode of delivery
2. Induction – delivery interval
3. Their rate of success