Induksi Sumber Definisi:
Induksi persalinan adalah sebuah upaya intervensi obstetrik buatan (menggunakan obat/mekanis/kombinasi) yang dilakukan untuk memicu persalinan pervaginam aktif sebelum adanya proses persalinan alami;
yang distimulasi melalui tahapan pembukaan cervix dan kontraksi uterus pada kehamilan >=28 minggu atas berbagai indikasi non- medis/medis yang ada pada ibu dan atau janin.
Induction of labor (IOL) is a common obstetric intervention that stimulates the onset of labor using artificial methods.
Tsakiridis, I., Mamopoulos, A., Athanasiadis, A., & Dagklis, T. (2020). Induction of Labor: An Overview of Guidelines.. Obstetrical & gynecological survey, 75 1, 61- 72 . https://doi.org/10.1097/ogx.0000000000000752.
Induction of labour is a two-step process involving cervical ripening and the initiation of uterine contractions, with the goal of achieving vaginal birth.
Banner, H., & D’Souza, R. (2021). Towards an evidence-based approach to optimize the success of labour induction.. Best practice & research. Clinical obstetrics & gynaecology. https://doi.org/10.1016/j.bpobgyn.2021.08.006.
Induction of labor is a method by which pregnancy is terminated artificially after 28 weeks of gestation for various indications.
Reshme, N., Samal, R., P, P., S., S., & K., R. (2017). Induction of labour: a randomized controlled trial. International journal of reproduction, contraception, obstetrics and gynecology, 6, 2512. https://doi.org/10.18203/2320-
1770.ijrcog20172342.
Induction of labor is a routine procedure in obstetrical care performed for various maternal, fetal, and non-medical reasons.
Blickstein, I. (2009). Induction of labour. The Journal of Maternal-Fetal &
Neonatal Medicine, 22, 31 - 37. https://doi.org/10.1080/14767050902860567.
Induction of labor is the initiation of regular uterine contractions to effect delivery before spontaneous labor begins.
Laube, D. (1997). Induction of labor.. Clinical obstetrics and gynecology, 40 3, 485- 95 . https://doi.org/10.1097/00003081-199709000-00006.
Indikasi:
Oligrohydramnion pada UK >36 minggu, IUGR tanpa masalah pada USG pada UK 38-39 minggu, IUGR + end-diastolic flow hilang pada UK 34 minggu, IUGR + reversed end diastolic flow pada UK 32 minggu, HT kronis tanpa pengobatan pada UK 38-39 minggu, HT gestasional pada UK >= 37 minggu, PE tanpa gejala berat pada UK >= 37 minggu, PE dengan gejala berat pada UK >= 34 minggu, Pre gestational diabetes terkontrol pada UK 39-40 minggu, Pre-term prelabour rupture of membrane/KPD pada UK >=34 minggu, Post-term UK 41-42 minggu,
Oligohydramnios with the timing at 36 0/7 to 37 6/7 weeks of gestation
Fetal intrauterine growth restriction, with no abnormal Doppler, with the timing at 38 0/7 to 39 6/7 weeks of gestation
Fetal intrauterine growth restriction, with absent end-diastolic flow, with the timing at 34 0/7 weeks of gestation
Fetal intrauterine growth restriction, with reversed end-diastolic flow, with the timing at 32 0/7 weeks of gestation
Chronic hypertension, not on medications, with the timing at 38 0/7 to 39 6/7 weeks of gestation
Abruptio plasenta, Korioamnionitis, IUFD, polihidramnion, oligohydramnion, Infeksi fetus/infeksi intrauterine.
Gestational hypertension with the timing at 37 0/7 weeks of gestation or at the time of diagnosis if diagnosed later
Preeclampsia without severe features with the timing at 37 0/7 weeks of gestation or at the time of diagnosis if diagnosed later
Preeclampsia with severe features with the timing at 34 0/7 weeks of gestation or at the time of diagnosis if diagnosed later
Pregestational diabetes well-controlled, with the timing at 39 0/7 to 39 6/7 weeks of gestation
Gestational diabetes (GDM), diet, or exercise controlled, with the timing at 39 0/7 to 40 6/7 weeks of gestation
Preterm prelabor rupture of membranes (PPROM) with the timing at 34 0/7 weeks of gestation or at the time of diagnosis if diagnosed later
Late-term with the timing at 41 0/7 to 41 6/7 weeks of gestation Abruptio placentae
Chorioamnionitis
Intrauterine fetal demise (IUFD)
ACOG committee opinion no. 560: Medically indicated late-preterm and early- term deliveries. (2013). Obstetrics and gynecology, 121(4), 908–910.
https://doi.org/10.1097/01.AOG.0000428648.75548.00
Indications of labor induction include post-term pregnancy, gestational hypertension, pre-eclampsia, oligohydramnios, and pre-labour rupture of membranes.
Noori, B., & Saeed, A. (2021). Indications of Labor Induction at Delivery Room of Maternity Teaching Hospital in Erbil City. Erbil Journal of Nursing and Midwifery.
https://doi.org/10.15218/EJNM.2021.05.
The commonest modern indication for labor induction is suspected placental deficiency, associated with pregnancy toxaemia or postmaturity.
Theobald, G. (1959). The choice between death from postmaturity or prolapsed cord and life from induction of labour.. Lancet, 1 7063, 59-65 .
https://doi.org/10.1016/S0140-6736(59)91135-3.
Indications for labor induction include post-term pregnancy, maternal
hypertension, premature rupture of membranes, fetal growth restriction, non- reassuring fetal status, polyhydramnios, intrauterine/fetal infection, and previous obstetric history.
Blickstein, I. (2009). Induction of labour. The Journal of Maternal-Fetal &
Neonatal Medicine, 22, 31 - 37. https://doi.org/10.1080/14767050902860567.
Kontra indikasi:
Plasenta previa, letak lintang, prolapsus tali pusar, Riwayat SC sebelumnya, infeksi herpes genital aktif, Riwayat miomektomi sebelumnya yang menembus rongga endometrium.
Vasa previa or placenta previa Transverse fetal presentation Umbilical cord prolapse
History of a prior classical cesarean section Active herpes infection
A previous myomectomy breaching the endometrial cavity
ACOG Practice Bulletin No. 107: Induction of labor. (2009). Obstetrics and gynecology, 114(2 Pt 1), 386–397. https://doi.org/10.1097/AOG.0b013e3181b48ef5 Cara:
Obat-obatan:
Oksitosin IV, Misoprostol (PGE2) (25-50 mcg)/Dinoproston (PGE1) Oral dan/atau vaginal, Mifepriston (Progestron blocker), Rivanol
Mekanis/Manual:
Enema bertekanan, laminaria tents, kateter balon/balloon-tipped catheters, bougies dilator
Lain-lain:
Teknik kombinasi
Dilatasi cervix menggunakan folley cateter (30 ml-80 ml) + Amniotomi + Oksitosin IV
Misoprostol is the preferred method for inducing labor in women with a previous caesarean section, as it reduces the risk of uterine rupture and is more effective than vaginal PGE2 inserts.
Józwiak, M., & Dodd, J. (2013). Methods of term labour induction for women with a previous caesarean section.. The Cochrane database of systematic reviews, 3, CD009792 . https://doi.org/10.1002/14651858.CD009792.pub2.
For cervical ripening with misoprostol, there is a range of doses and routes of administration, such as orally, vaginally, or sublingually. Doses of misoprostol range from 25 micrograms (mcg) to 50 mcg.
ACOG Practice Bulletin No. 107: Induction of labor. (2009). Obstetrics and gynecology, 114(2 Pt 1), 386–397. https://doi.org/10.1097/AOG.0b013e3181b48ef5 PGE2 (dinoprostone) is available as a vaginal insert and gel formulation. The gel formulation is available in 0.5 mg, and the insert is 10 mg.
ACOG Practice Bulletin No. 107: Induction of labor. (2009). Obstetrics and gynecology, 114(2 Pt 1), 386–397. https://doi.org/10.1097/AOG.0b013e3181b48ef5 Mechanical methods for labor induction include pressurized douches, extra- amniotic aqua picea, laminaria tents, balloon-tipped catheters, and bougies.
Sciscione, A. (2014). Methods of Cervical Ripening and Labor Induction:
Mechanical. Clinical Obstetrics and Gynecology, 57, 369–
376. https://doi.org/10.1097/GRF.0000000000000023.
A Foley catheter is passed through the external and the internal cervical os. The balloon is then inflated, between 30 milliliters (mL) to 80 mL with normal saline, and the balloon exerts pressure on the internal os to help with cervical dilation
ACOG Practice Bulletin No. 107: Induction of labor. (2009). Obstetrics and gynecology, 114(2 Pt 1), 386–397. https://doi.org/10.1097/AOG.0b013e3181b48ef5
A 2012 American Journal of Obstetrics and Gynecology (AJOG) article
demonstrated that an 80 mL inflation volume resulted in a faster induction and less need for syntocinon compared to a volume of 30 mL.
Gu, N., Ru, T., Wang, Z., Dai, Y., Zheng, M., Xu, B., & Hu, Y. (2015). Foley Catheter for Induction of Labor at Term: An Open-Label, Randomized Controlled Trial. PloS one, 10(8), e0136856. https://doi.org/10.1371/journal.pone.0136856
Inducing labor has evolved from dietary delicacies and verbal threats to sophisticated pharmacological manipulation using oxytocin and prostaglandins, with safety, success, and patient satisfaction being the major objectives.
MacKenzie, I. (2006). Induction of labour at the start of the new
millennium.. Reproduction, 131 6, 989-98 . https://doi.org/10.1530/REP.1.00709.
Combining amniotomy and intravenous oxytocin is generally the most effective labor induction technique for women with favorable cervixes.
Penfield, C., & Wing, D. (2017). Labor Induction Techniques: Which Is the Best?.
Obstetrics and gynecology clinics of North America, 44 4, 567-582 . https://doi.org/10.1016/j.ogc.2017.08.011.
Foley catheter for cervical ripening followed by amniotomy and oxytocin titration is the safest and most effective method for labor induction.
Orhue, A. (1995). Induction of labour at term in primigravidae with low Bishop's score: a comparison of three methods.. European journal of obstetrics, gynecology, and reproductive biology, 58 2, 119-25 . https://doi.org/10.1016/0028-
2243(95)80009-H.
Foley balloon catheter is a more widely accepted non-hormonal method for labor induction, but other methods require further evidence for their use in clinical settings.
Lim, C., Ng, R., & Xu, K. (2013). Non-hormonal methods for induction of labour. Current Opinion in Obstetrics and Gynecology, 25, 441–
447. https://doi.org/10.1097/GCO.0000000000000027.
Oral misoprostol is safer than vaginal misoprostol and has the lowest rate of caesarean section for induction of labor.
Weeks, A., Navaratnam, K., & Alfirevic, Z. (2017). Simplifying oral misoprostol protocols for the induction of labour. Bjog, 124, 1642 - 1645.
https://doi.org/10.1111/1471-0528.14657.
Prostaglandins, such as Dinoprostone and Misoprostol, are the most common and safest methods for labor induction, with oxytocin being an effective adjunct.
Tinelli, A., Tinelli, R., & Tinelli, F. (2003). [Induction of labour: which method to use?].. Minerva ginecologica, 55 6, 463-82.
The best method for midtrimester induction of labor is combined administration with misepristone and rivanol.
Ye, R. (2001). Investigation of methods for midtrimester induction of labor.
Journal of Hangzhou Medical College.
Augmentasi Sumber
Definisi:
Augmentasi persalinan adalah proses merangsang rahim untuk meningkatkan frekuensi, durasi dan intensitas kontraksi setelah permulaan persalinan spontan yang inadekuat.
Augmentation of labour is the process of stimulating the uterus to increase the frequency, duration and intensity of contractions after the onset of spontaneous labour.
WHO Recommendations for Augmentation of Labour. Geneva: World Health Organization; 2014. Executive summary. Available from:
https://www.ncbi.nlm.nih.gov/books/NBK258881/
Indikasi:
Primer: Penambahan bukaan <1 cm/jam pada multipara, dan <0,5 cm/jam pada nullipara selama fase aktif (antara pembukaan 3-7 cm).
Sekunder: Tidak ada bukaan lanjutan/bukaan lambat antara pembukaan 7-10 cm.
Cara:
Obat-obatan: Misoprostol PO/SL, Oksitosin IV, Drotaverine HCl PO Non-farmakologis: Amniotomi, Stimulasi payudara
Sublingual misoprostol is a safe and effective drug for augmentation of labor leading to early delivery without any major side effects.
Verma, A., Gupta, A., & Kashyap, M. (2019). Sublingual Misoprostol for labour augmentation. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. https://doi.org/10.18203/2320-1770.IJRCOG20191062.
Breast stimulation has been shown to be effective in ripening the cervix, inducing labor, and as an alternative to oxytocin for the contraction stress test.
Curtis, P., Resnick, J., Evens, S., & Thompson, C. (1999). A comparison of breast stimulation and intravenous oxytocin for the augmentation of labor.. Birth, 26 2, 115-22 . https://doi.org/10.1046/J.1523-536X.1999.00115.X.
Oxytocin augmentation can hasten labor, shorten the time to delivery, and potentially reduce the risk of cesarean delivery, especially in women with longer labors or less frequent contractions.
Kernberg, A., & Caughey, A. (2017). Augmentation of Labor: A Review of Oxytocin Augmentation and Active Management of Labor.. Obstetrics and gynecology clinics of North America, 44 4, 593-600 . https://doi.org/10.1016/j.ogc.2017.08.012.
Oxytocin in labor augmentation increases the volume of blood loss during vaginal delivery.
Mansy, A. (2017). Does Labor Augmentation with Oxytocin Increase the Risk of Postpartum Hemorrhage? A Randomized Controlled Trial. clinics in Mother and Child Health, 14, 1-6. https://doi.org/10.4172/2090-7214.1000268.
Drotaverine hydrochloride effectively augments labor without serious adverse effects on mother and fetus.
Tile, R., & Jamkhandi, S. (2019). To study the efficacy and safety of Drotaverine hydrochloride in augmentation of labour. Obsgyne Review: Journal of Obstetric and Gynecology. https://doi.org/10.17511/joog.2019.i01.14.
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