怎么样才能早点生配图，仅供参考
Methods of inductionFetal maturity should first be assessed. The presentation and position of the fetus should be rechecked just before induction.
The simplest procedure is to sweep the membranes with a gloved finger lubricated with antiseptic cream and inserted gently up the cervical canal. If performed by an experienced doctor or midwife,this need not be uncomfortable. After 40 weeks’ gestation,this procedure can halve the subsequent need for further induction,but at 38-40 weeks it does not significantly increase the proportion of women who go into labour within 7 days.
The traditional method of induction is to rupture the membranes,releasing amniotic fluid. The forewaters can be snagged with a simple Amnihook (EMS Medical Group),a pair of Kocher’s forceps,or a pair of special amniotomy forceps. Under sterile conditions the chosen instrument is passed through the cervical canal. Under vision or digital pilotage,the forewaters are snagged. The colour of the amniotic fluid and the volume released should be assessed. The fetal heart rate should be checked immediately afterwards to ensure no fetal compromise,but it is unnecessary to continue with cardiotocography unless there is a specific indication.
Puncture of the hindwaters used to be done with a Drew Smythe catheter,an S shaped metal catheter. Although not often performed in Britain these days,this procedure is still useful in many parts of the world where access to caesarean section may be difficult. It is used for inducing a woman with an unstable lie when the fetal head is wandering out of the pelvis and needs to be stabilised.
# Prostaglandins
The commonest method of induction in current use in the United Kingdom is with prostaglandin gel or pessaries placed high in the vagina. These hormones are the same as those produced by the uterus in early labour,so it is a more natural method than using oxytocic agents. Also,cells that have been primed with prostaglandin gel are more likely to respond if intravenous oxytocin is needed.
Prostaglandins can be given intravenously,intramuscularly,orally,or vaginally,but the first three routes often produce severe side effects and are best avoided in labour. Currently,in Britain,1 mg or 2 mg of prostaglandin E2a is given in a gel. It is absorbed into the circulation through the vaginal and cervical epithelium,returning in the blood supply to the uterus. An obstetrician or midwife starting an induction with prostaglandin gel should stay with the woman for 20-30 minutes in case of a myometrial overreaction,and cardiotocography monitoring of the fetus is wise.
If labour is not established and the cervix is not dilating after four to six hours,the same dose of prostaglandin gel may be repeated. After this,most obstetricians would advise a low rupture of the membranes if the cervix was sufficiently dilated,usually with Syntocinon intravenously. Such a mixture should be handled with care,with a midwife constantly in attendance to observe the strength of the uterine contractions.
# Syntocinon
This synthetically produced oxytocic is given intravenously,with the dose titred against the myometrial response. For safety reasons either a very dilute solution is used or a mechanical pump is preset to inject small amounts of the concentrated agent into a dextrose saline drip. Rarely is Syntocinon used alone to induce labour; its help is more to augment existing labour after the artificial rupture of the membranes or stimulation with prostaglandin gel.","department":"
