Oestrogen also increases the no. of oxytocin receptors. This has to be clearly distinguished from augmentation of labour where an external agent is used or a procedure is performed to enhance uterine contractions after the onset of spontaneus labour. The concept is to terminate the pregnancy when prolongation of the pregnancy carries a higher risk to the mother, fetus or to both. Generally, a cervical Bishop score of less than 5 is considered unfavourable for induction. There is a higher incidence of failed induction and perinatal mortality and morbidity in this group.
Induction is normally with a synthetic vaginal prostaglandin. .
Sweep and stretch Done with gloved fingers, lubricated with gel or antiseptic cream Cervix is stretched. Positive feedback for oxytocin. Membrane is swept to separate it from the lower uterine segment. No need for tedious maternal or fetal monitoring. When the cervix is favourable.