©Pregnancy bliss 2008
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Labor augmentation
Labor augmentation differs from labor induction in the sense that it applies only in cases where labor is already established.
If labor is already underway, that is; the cervix has started to open and the uterus is contracting regularly but progress is unsatisfactory, labor augmentation is indicated.
Unsatisfactory labor progress
Progress is judged by what is found to be happening to the cervix and the presenting part of the baby. Vaginal examination is the only way of verifying labor progress.
The cervix should dilate progressively and the minimum acceptable rate of dilatation is 1 cm per hour. The leading part of the baby should descend continually down the pelvic canal.
If serial examinations reveal that cervical dilatation is not taking place at the acceptable rate, it may be time to consider augmenting labor.
Augmenting breech labor
Most obstetricians contend that labor augmentation has no place in breech presentation.
Where vaginal breech delivery is practiced, poor labor progress in breech presentation is regarded as a warning sign of a possible difficult delivery and hence an indication for cesarean delivery. An experienced obstetrician will usually use his or her judgment on how best to proceed in each individual case.
The use of oxytocin drips in breech presentation is certainly a contentious issue.
Failed labor augmentation
In some cases, in spite of prolonged use of an oxytocin infusion at the highest allowable concentrations, labor progress remains sluggish, even stagnant. The reason for this is not always clear. In any case, such a situation is an indication for cesarean delivery.
Other facts about labor augmentation
v Prostaglandins cannot be used to augment labor. Oxytocin infusion is the only safe and effective method.
v Oxytocin can only be administered continuously as an infusion. It is given in well
controlled and, if necessary, incremental rates. There is no option for a one-
Dictionary
aug·men·ta·tion [àwgmən táysh'n, àwg men táysh'n]
(plural aug·men·ta·tions)
noun
1. increase: the increasing, or growth, of something in number, amount, size, strength, or intensity, or the amount by which something grows or is added to
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