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Wirral University Hospital NHS Foundation Trust

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Induction of Labour

There are 2 methods of induction used at Wirral Women and Children’s Hospital, depending on clinical examination and cervical assessment

Prostaglandin Vaginal Pessaries/Tampons

If the Bishop’s score is below 8 points, prostaglandin pessaries are the induction method of choice. Individual condition determines which is more suitable.

  • Prostin tampon is inserted and left for up to 24 hours or until labour begins or
  • Pessary is placed behind the cervix, at the top of the vagina where it dissolves
  • Hormones in the pessary cause the cervix to soften and the uterus to contract
  • If labour has not begun 6 hours later, the process is repeated
  • A 3rd pessary is sometimes given the following day, if indicated

Artificial Rupture of Membranes and Syntocinon

If the Bishop’s score is 8 or above, artificial rupture of membranes (ARM) can be performed. This should be no more uncomfortable than any other vaginal examination.

  • Small, slim instrument is used to nick the bag of membranes, releasing some of the water.
  • Often this is sufficient stimulation for the uterus to start contracting and labour begins
  • An intravenous infusion of a hormone called syntocinon can be used to stimulate the uterus to begin contracting.