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Induction of labor

Thursday, August 23rd 2012. | Pregnancy

What is a “trigger”?

It is a medical procedure designed to induce labor.

In practice, it is occurred to cause uterine contractions while “maturant” the cervix, that is to say, making it more conducive to dilate, and therefore to deliver.

This uterine contractions associated with cervical dilation is called “development work”.

The purpose of a trip is to artificially reproduce what happens in a work setting natural or spontaneous.

Induction of labor

Induction of labor (img thanks to nurturingheartsbirthservices.com)

What are the situations leading up to create a trigger?

There are basically two types of situations that may lead to induce labor:

  • Medical indications
  • Triggers convenience

Medical indications are numerous:

  • When your pregnancy comes to an end and that the implementation spontaneous labor has not occurred. Thus, to prevent the occurrence of potential complications during this time is exceeded run, a trigger will be realized.
  • It will be a table even before rupture of membranes without formal work hours / days thereafter,
  • Pathologies such as growth retardation in utero , gestational diabetes unbalanced significant decrease in the volume of amniotic fluid, hypertension or preeclampsia table, bring to induction of labor.

It is important to note that induction of labor for medical indications can of course take place in the period when the fetus is at term (37 weeks gestation (WG) and 41SA 4 days), but also in an earlier period (before 37) leading thus to a premature birth. These triggers will only occur if the continuation of pregnancy poses a significant risk to the mother and / or fetus.

Relating to the initiation of convenience, it has the characteristic of being done after 39 SA in the absence of complications in the mother and / or fetus. It is the result of an agreement between the patient and his doctor, after being informed of the ins and outs of such a gesture and potential risks associated with its implementation. This type of trigger is only performed when the cervix is favorable because said otherwise the risk of cesarean for failure triggering increased.

Examples of triggering convenience can be a husband who is regularly on the move, a couple living near the maternity or example to logistical reasons in case of other infants.

How is the trigger?

Before making a trip, it is necessary to evaluate the cervical status, that is to say whether the cervix is closed and tonic, bringing enough to offer a sustained release (known as cervical ripening), or if the otherwise the cervix is already dilated and softened, causing a trigger to think “simple” could allow the patient to deliver quickly.

  • If the cervix is not favorable, the midwife will have a gel into the vagina or a small buffer containing prostaglandin, a substance having the ability to “ripen” the cervix and cause uterine contractions. This trigger is made in fetal monitoring to detect possible poor tolerance of the baby uterine contractions which may in some cases too frequent or too intense.
  • If the cervix is favorable, it is not necessary to ripen the cervix. Depending on the case, the midwife may need to be, breaking the amniotic sac, or membranes off with his finger, or administer oxytocin infusion. All these methods aim to show uterine contractions that once implemented, will go to the patient in a dynamic work.

What are the risks of tripping / maturation?

Making a trip or cervical ripening this as any medical risk that must be informed.

These risks are represented mainly by an increase in the cesarean section rate, extraction instrumental (forceps) and / or episiotomy, and uterine rupture rarely (if history of surgery on the uterus). There is also an increased risk of postpartum hemorrhage because of the work that may be longer than spontaneous labor.

Are there any cons-indications to the realization of a trigger?

Quite logically, against all reason indicating a natural vaginal delivery, also represents a cons-indication to a trigger (transverse lie, placenta covering …).

Moreover, having already received several caesareans during a previous pregnancy is a cons-indication usual a possible trigger.

Breech presentation or twins do not represent situations indicating a trigger-cons.

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