ACOG issues Working revision GuidelinesWashington induction, DC Revised guidelines on when and how to induce labor in pregnant women were issued today by the American College of Obstetricians and Gynecologists (ACOG). The guidelines provide physicians with guidance on methods of induction may be more appropriate to the particular circumstances and security requirements and the risks and benefits of different methods. ACOG Practice Bulletin quot; Trabajoquot induction, is published in the August 2009 edition of Obstetrics Gynecology. br The rate of induction of labor in the U.S. has more than doubled since 1990. In 2006, more than 22% (approximately 1 in 5) of all pregnant women had their labor induced. The goal of induction of labor is artificially stimulate uterine contractions that pregnant women can deliver vaginally. As with all procedures, risks must be weighed against the benefits to the woman and fetus. br quot; There are certain health conditions, either the woman or the fetus, where the benefit of labor induction is very claraquot;, said Susan Ramin, MD, University of Texas Medical School at Houston, who helped lead development ACOG Practice Bulletin. quot; And there are some situations where nonmedical induction may also be prudent, for example, in rural areas where distance to the hospital is too great to risk waiting to happen spontaneous labor in hogar.quot; In circumstances like these the ACOG recommendations say that the gestational age of fetus must determine that at least 39 weeks or fetal lung maturity should be established before induction. br Cervical ripening is the first component of labor induction. If the cervix is not dilated enough, then drugs or mechanical cervical dilators should be used to ripen the cervix before inducing labor. Once the cervix dilates, labor can be induced with oxytocin, rupture, rupture of the amniotic membrane, or nipple stimulation. Misoprostol, a drug for peptic ulcers, is commonly used offlabel drug that both mature and cervix to induce labor. The ACOG guidelines state that labor induction with misoprostol be avoided in women who have had even a prior cesarean delivery because of the possibility of uterine rupture (which can be catastrophic). br According to ACOG, there are a number of health conditions that may justify induce labor but doctors should consider maternal and infant conditions, the condition of the cervix, gestational age and other factors. Some examples that indicated labor induction include (but are not limited to) chronic or gestational hypertension, preeclampsia, eclampsia, diabetes, premature rupture of membranes, severe fetal growth restriction, and postterm pregnancy. br quot; There are certain situations where the induction is contraindicated partoquot, says Dr. Ramin. These situations include (but are not limited to) the transverse fetal position, cord prolapse, active genital herpes infection, placenta previa, and women who have had a previous myomectomy (fibroid removal) from inside the uterus, as ACOG. br quot; A doctor can perform a caesarean section should be available throughout the induction time is used in the event that the induction is not successful in producing vaginalquot delivery, says Dr. Ramin. Although rare, there are potential complications with some methods of labor induction. quot; These guidelines will help doctors use the most appropriate method depending on the unique characteristics of the pregnant woman and her feto.quot; br br
