See also: Preterm labour Previous caesarean section
If a woman has PPROM after 34 weeks, the decision to undertake IOL should consider the balance of risks and benefits for the woman and baby and the local availability of Special Care or Neonatal Intensive Care nursery facilities. If a woman has PPROM before 34 weeks, IOL should not be carried out unless there are additional obstetric indications (for example, infection or fetal compromise). See also: Group B streptococcus sepsis (GBS) prevention for neonates Preterm pre-labour rupture of membranes (PPROM) abnormal CTG not requiring immediate delivery.In the following circumstances, IOL should be commenced as soon as possible after PROM: Timing of IOL may also be influenced by local conditions for example, some health services will prefer to commence IOL when staffing levels are optimal for managing an oxytocin infusion. IOL is appropriate within 24 hours of term PROM. Pre-labour rupture of membranes at term (Term PROM) The exact timing of IOL should take into account the woman's preferences and local health service organisational circumstances. To avoid the risks associated with prolonged pregnancy, women with uncomplicated pregnancies should be offered IOL between 41+0and 42+0 weeks. Women with uncomplicated pregnancies should be given every opportunity to go into spontaneous labour. If the LNMP was not certain, or menstruation irregular, use an EDD estimate from an ultrasound performed between six and 24 weeks. If the dates differ by >10 days, use the ultrasound EDD. If the two dates differ by 10 days or less, use the LNMP EDD.
Term PROM - GBS positive, meconium liquor, suspected sepsis IOL indications and recommendations - summary Indication This guidance draws on current evidence to offer advice on the care of women for whom IOL is recommended or undertaken. When planning inductions of labour, hospitals should take into account the need for additional resources and plan staffing numbers and skill mix accordingly. Continuous intrapartum fetal surveillance, management of oxytocin infusions and longer periods of 'observed' labour all add to the workload. IOL usually consumes more healthcare resources than spontaneous labour. When labour was induced, 57 per cent of women went on to have a spontaneous vaginal birth, 22 per cent of women had an instrumental birth and 21 per cent gave birth by caesarean section.Īs with all clinical interventions, IOL should be clinically justified, weighing the risks of the induction against the risks of continuing the pregnancy. In Victoria in 20, 25 per cent of labours were induced. Induction of labour (IOL) is a common procedure undertaken by maternity service providers. We recommend that you also refer to more contemporaneous evidence in the interim. Please note that all guidance is currently under review and some may be out of date.
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