Product Description.:
Remember that this sheet does not give you all of the information about CERVIDIL and cervical ripening. If you have any concerns or other questions about CERVIDIL ask your LMC (Lead Maternity Caregiver ? Doctor or Midwife).
What is an Induction?
An Induction is the process of starting labour artificially instead of waiting for it to occur naturally. An induction will only be commenced if there is a compelling medical reason to do so as there are increased risks with assisted and caesarean section deliveries. Your Lead Maternity Carer (Doctor or Midwife) will discuss this with you and your Family/ Whanau and can answer any questions that you may have. Inductions are recommended when the health of the mother and/or baby will benefit.
Why do I need to be Induced?
Some babies may need to be delivered before labour starts spontaneously. Common reasons for inductions include High Blood Pressure, Diabetes, Bleeding as well as problems with the baby or because they are overdue. The reason you are being recommended for Induction will be discussed with you and your consent sought.
How will I be Induced?
Your LMC (Doctor or Midwife) has prescribed CERVIDIL to induce your labour. This is a slow release Prostaglandin. It contains a hormone similar to those produced naturally by your body which helps to stimulate labour. It helps prepare your cervix for labour (this is known as ?cervical ripening?).This information sheet gives you answers to some common questions about cervical ripening and CERVIDIL from a patient?s perspective. Please ask your LMC if you require more detailed information
What happens during Induction?
Your LMC will arrange for you to be admitted to the hospital as an in-patient.
Induction is a 3 stage process and the time it takes varies with each woman and their response.
? Prior to starting the Induction the process will be explained to you and your baby?s heart rate will be checked with a CTG monitor. A vaginal examination will then be carried out to check your cervix and to insert CERVIDIL.
? Once the cervix has softened and shortened the next stage is rupturing the membranes. The membranes may break by themselves but will often be broken as part of the Induction process. This will help labour to become established. You will then be transferred to the labour & birthing suite.
? Cervidil may be removed and after waiting for 30 minutes an IV (Intravenous) drip containing a hormone called Syntocinon may be given. It is used to stimulate contractions. You and your baby will continue to be monitored closely.
The pessary (vaginal insert) can be removed quickly and easily by gentle traction on the retrieval tape. After removal ensure that the entire product, pessary (vaginal insert) and retrieval system, has been removed from the vagina. It is necessary to remove the pessary (vaginal insert) to terminate drug administration when cervical ripening is judged to be complete or for any of the reasons listed below.
1. Onset of labour. For the purposes of induction of labour with CERVIDIL, the onset of labour is defined as the presence of regular painful uterine contractions occurring every 3 minutes irrespective of any cervical change. There are two important points to note:
i) Once regular, painful contractions have been established with CERVIDIL, they will not reduce in frequency or intensity as long as CERVIDIL remains in situ because PGE2 is still being administered, nor will they reduce if CERVIDIL? is removed because the woman is in labour or
ii) Patiens, particularly multigravidae, may develop regular painful contractions without any apparent cervical change. Effacement and dilatation of the cervix may not occur until uterine activity is established. Because of this, once regular painful uterine activity is established with CERVIDIL in situ, the pessary (vaginal insert) should be removed irrespective of cervical state to avoid the risk of uterine hyperstimulation.
2. Spontaneous rupture of the membranes or amniotomy.
3. Any suggestion of uterine hyperstimulation or hypertonic uterine contractions.
4. Evidence of foetal distress.
5. Evidence of maternal systemic adverse PGE2 effects such as nausea, vomiting, hypotension or tachycardia.
6. At least 30 minutes prior to starting an intravenous infusion of oxytocin.
7. If there has been insufficient cervical ripening in 24 hours.
On removal of the product from the vagina, the pessary (vaginal insert) will have swollen to 2-3 times its original size and be pliable.
There are several pain relief options which should be discussed with your LMC during your pregnancy and prior to starting the induction so that you know what is available.
