Complications of labor induction

A. Hyperstimulation and tachysystole may occur with use of prostaglandin compounds or oxytocin. Hyperstimulation is defined as uterine contractions lasting at least two minutes or five or more uterine contractions in 10 minutes. Tachysystole is defined as six or more contractions in 20 minutes.

B. Prostaglandin E2 (PGE2) preparations have up to a 5 percent rate of uterine hyperstimulation. Fetal heart rate abnormalities can occur, but usually resolve upon removal of the drug. Rarely hyperstimulation or tachysystole can cause uterine rupture. Removing the PGE2 vaginal insert will usually help reverse the effects of the hyperstimulation and tachysystole. Cervical and vaginal lavage after local application of prostaglandin compounds is not helpful.

C. If oxytocin is being infused, it should be discontinued to achieve a reassuring fetal heart rate pattern. Placing the woman in the left lateral position, administering oxygen, and increasing intravenous fluids may also be of benefit. Terbutaline 0.25 mg subcutane-ously (a tocolytic) may be given.

References: See page 184.

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