Macrosomia.txt · clinical obstetrics
medical · cause to happen
Infinitive. to bring on
Past. brought on
Past participle. brought on
Gerund. bringing on
Labor induction is the use of medications or other methods to bring on (induce) labor.
Actors: Labor induction, medications, methods, labor
Group. medications, methods
Done to: labor
Labor induction is the use of medications or other methods to bring on (induce) labor.
Actors: Labor induction, medications, methods, labor
Group. medications, methods
Done to: labor
medical · stimulate labor
Infinitive. to induce
Past. induced
Past participle. induced
Gerund. inducing
Labor is induced to stimulate contractions of the uterus in an effort to have a vaginal birth.
Actors: Labor, contractions, uterus, vaginal birth
Done to: labor
In order to: stimulate contractions of the uterus in an effort to have a vaginal birth
One approach to try to reduce this trauma has been to induce labor early, so that we may deliver before the baby grows too big.
Actors: approach, trauma, labor, we, baby
Group. we
Done to: labor
At time: early
In order to: deliver before the baby grows too big
Although some parents and doctors may feel the existing evidence is sufficient to justify inducing labor, others may disagree.
Actors: parents, doctors, evidence, labor, others
Group. parents, doctors
Done to: labor
Further high-quality studies are needed to find out what is the best time to induce labor towards the end of pregnancy and how to improve the accuracy in diagnosing macrosomia.
Actors: high-quality studies, time, labor, pregnancy
Done to: labor
At time: towards the end of pregnancy
Sometimes when labor is going to be induced, the cervix is not yet "ripe" or soft.
Actors: labor, cervix
Done to: labor
At time: Sometimes
medical · employ a method or medication
Infinitive. to use
Past. used
Past participle. used
Gerund. using
Labor induction is the use of medications or other methods to bring on (induce) labor.
Actors: Labor induction, medications, methods, labor
Done to: medications or other methods
Labor induction is the use of medications or other methods to bring on (induce) labor.
Actors: Labor induction, medications, methods, labor
Done to: medications or other methods
The Bishop score may be used to rate the readiness of the cervix for labor.
Actors: Bishop score, cervix, labor
Done to: Bishop score
In order to: rate the readiness of the cervix for labor
Medications or devices may be used to soften the cervix so it will stretch for labor.
Actors: Medications, devices, cervix, labor
Done to: Medications or devices
In order to: soften the cervix so it will stretch for labor
Prostaglandins are medications that can be used to ripen the cervix.
Actors: Prostaglandins, medications, cervix
Done to: Prostaglandins
In order to: ripen the cervix
One risk is that when oxytocin is used, the uterus may be overstimulated.
Actors: risk, oxytocin, uterus
Done to: oxytocin
medical · cause to contract or act
Infinitive. to stimulate
Past. stimulated
Past participle. stimulated
Gerund. stimulating
Labor is induced to stimulate contractions of the uterus in an effort to have a vaginal birth.
Actors: Labor, contractions, uterus, vaginal birth
Done to: contractions of the uterus
medical · give birth to or experience
Infinitive. to have
Past. had
Past participle. had
Gerund. having
Labor is induced to stimulate contractions of the uterus in an effort to have a vaginal birth.
Actors: Labor, contractions, uterus, vaginal birth
Done to: vaginal birth
Macrosomic babies can have difficult and occasionally traumatic births.
Actors: Macrosomic babies, births
Living thing. Macrosomic babies
Done to: difficult and occasionally traumatic births
Women with large-for-dates fetuses are more likely to have labor augmentation and caesarean section, more serious perineal trauma, and more severe morbidity.
Actors: Women, large-for-dates fetuses, labor augmentation, caesarean section
Individual. Women with large-for-dates fetuses
Done to: labor augmentation and caesarean section, more serious perineal trauma, and more severe morbidity
Some prostaglandins are not used if you have had a previous cesarean birth or other uterine surgery to avoid increasing the possible risk of uterine rupture.
Actors: prostaglandins, cesarean birth, uterine surgery
Done to: previous cesarean birth or other uterine surgery
In addition, the number of cesarean births you have had is a major factor in how you will give birth to any future babies.
Actors: cesarean births, you, factor, future babies
Done to: cesarean births
medical · advise as a course of action
Infinitive. to recommend
Past. recommended
Past participle. recommended
Gerund. recommending
Labor induction may be recommended if the health of the mother or fetus is at risk.
Actors: Labor induction, health, mother, fetus
Done to: Labor induction
Condition: if the health of the mother or fetus is at risk
medical · require as necessary
Infinitive. to need
Past. needed
Past participle. needed
Gerund. needing
Sometimes labor induction may be needed even if it means that the fetus will be born early.
Actors: labor induction, fetus
Done to: labor induction
Further high-quality studies are needed to find out what is the best time to induce labor towards the end of pregnancy and how to improve the accuracy in diagnosing macrosomia.
Actors: high-quality studies, time, labor, pregnancy
Done to: Further high-quality studies
Other treatments may be needed to steady the fetal heart rate.
Actors: Other treatments, fetal heart rate
Done to: Other treatments
In order to: steady the fetal heart rate
If you or your baby is not doing well during or after attempting induction, a cesarean birth may be needed.
Actors: you, baby, induction, cesarean birth
Done to: a cesarean birth
general · signify or entail
Infinitive. to mean
Past. meant
Past participle. meant
Gerund. meaning
Sometimes labor induction may be needed even if it means that the fetus will be born early.
Actors: labor induction, fetus
Done to: that the fetus will be born early
Suspected large babies may tun out to be smaller than expected at delivery, which means parents might be worried unnecessarily and might undergo induction of labor without any benefit.
Actors: large babies, delivery, parents, induction, labor, benefit
Done to: parents might be worried unnecessarily and might undergo induction of labor without any benefit
This means that labor cannot progress.
Actors: labor
Done to: that labor cannot progress
A Bishop score of less than 6 means that your cervix may not be ready for labor.
Actors: Bishop score, cervix, labor
Done to: that your cervix may not be ready for labor
medical · come into the world as an infant
Infinitive. to be born
Past. was born
Past participle. born
Gerund. being born
Sometimes labor induction may be needed even if it means that the fetus will be born early.
Actors: labor induction, fetus
Living thing. fetus
In these cases, the risks of continuing the pregnancy are judged to outweigh the risks of the fetus being born too early.
Actors: risks, pregnancy, fetus
Living thing. fetus
general · prolong or persist
Infinitive. to continue
Past. continued
Past participle. continued
Gerund. continuing
In these cases, the risks of continuing the pregnancy are judged to outweigh the risks of the fetus being born too early.
Actors: risks, pregnancy, fetus
Done to: the pregnancy
general · form an opinion or evaluation
Infinitive. to judge
Past. judged
Past participle. judged
Gerund. judging
In these cases, the risks of continuing the pregnancy are judged to outweigh the risks of the fetus being born too early.
Actors: risks, pregnancy, fetus
Done to: the risks of continuing the pregnancy
general · be greater or more significant than
Infinitive. to outweigh
Past. outweighed
Past participle. outweighed
Gerund. outweighing
In these cases, the risks of continuing the pregnancy are judged to outweigh the risks of the fetus being born too early.
Actors: risks, pregnancy, fetus
Done to: the risks of the fetus being born too early
general · allude or mean
Infinitive. to refer
Past. referred
Past participle. referred
Gerund. referring
MACROSOMIA refers to a baby who is very large at the time of birth.
Actors: MACROSOMIA, baby, time, birth
Done to: a baby who is very large at the time of birth
general · attempt
Infinitive. to try
Past. tried
Past participle. tried
Gerund. trying
One approach to try to reduce this trauma has been to induce labor early, so that we may deliver before the baby grows too big.
Actors: approach, trauma, labor, we, baby
Done to: reduce this trauma
medical · make smaller or less
Infinitive. to reduce
Past. reduced
Past participle. reduced
Gerund. reducing
One approach to try to reduce this trauma has been to induce labor early, so that we may deliver before the baby grows too big.
Actors: approach, trauma, labor, we, baby
Done to: this trauma
In Macrosomic babies, induction of labor before term has been shown to reduce SHOULDER DYSTOCIA, which is when the baby's shoulder becomes stuck during vaginal delivery.
Actors: Macrosomic babies, induction, labor, SHOULDER DYSTOCIA, baby, shoulder, vaginal delivery
Done to: SHOULDER DYSTOCIA
The purpose of labor induction at or shortly before term (37 to 40 weeks) in case of suspected fetal macrosomia is to reduce the likelihood of a difficult birth, possibly resulting in maternal or perinatal morbidity.
Actors: purpose, labor induction, term, fetal macrosomia, likelihood, difficult birth, maternal or perinatal morbidity
Done to: the likelihood of a difficult birth
Observational studies cast doubts on the effectiveness of such a policy and have suggested that induction increases the risk of caesarean section without reducing birth injury.
Actors: Observational studies, doubts, effectiveness, policy, induction, risk, caesarean section, birth injury
Done to: birth injury
If there are problems with the fetal heart rate, oxytocin may be reduced or stopped.
Actors: problems, fetal heart rate, oxytocin
Done to: oxytocin
medical · bring forth a baby
Infinitive. to deliver
Past. delivered
Past participle. delivered
Gerund. delivering
One approach to try to reduce this trauma has been to induce labor early, so that we may deliver before the baby grows too big.
Actors: approach, trauma, labor, we, baby
Group. we
In order to: before the baby grows too big
biological · increase in size
Infinitive. to grow
Past. grew
Past participle. grown
Gerund. growing
One approach to try to reduce this trauma has been to induce labor early, so that we may deliver before the baby grows too big.
Actors: approach, trauma, labor, we, baby
Living thing. baby
Intensity: too big
general · demonstrate or prove
Infinitive. to show
Past. showed
Past participle. shown
Gerund. showing
In Macrosomic babies, induction of labor before term has been shown to reduce SHOULDER DYSTOCIA, which is when the baby's shoulder becomes stuck during vaginal delivery.
Actors: Macrosomic babies, induction, labor, SHOULDER DYSTOCIA, baby, shoulder, vaginal delivery
Done to: induction of labor before term
medical · get lodged or wedged
Infinitive. to become stuck
Past. became stuck
Past participle. become stuck
Gerund. becoming stuck
In Macrosomic babies, induction of labor before term has been shown to reduce SHOULDER DYSTOCIA, which is when the baby's shoulder becomes stuck during vaginal delivery.
Actors: Macrosomic babies, induction, labor, SHOULDER DYSTOCIA, baby, shoulder, vaginal delivery
Living thing. baby's shoulder
During: vaginal delivery
general · take place or happen
Infinitive. to occur
Past. occurred
Past participle. occurred
Gerund. occurring
However, when bone fractures occur, they are usually to the clavicle, which heals well without long-term consequences.
Actors: bone fractures, clavicle, long-term consequences
Made object. bone fractures
Medical problems that were present before pregnancy or occurred during pregnancy may contribute to these complications.
Actors: Medical problems, pregnancy, complications
Group. Medical problems
During: pregnancy
medical · return to a healthy state
Infinitive. to heal
Past. healed
Past participle. healed
Gerund. healing
However, when bone fractures occur, they are usually to the clavicle, which heals well without long-term consequences.
Actors: bone fractures, clavicle, long-term consequences
Made object. clavicle
How: well without long-term consequences
biological · direct signals or objects
Infinitive. to send
Past. sent
Past participle. sent
Gerund. sending
Even though there is the benefit of reduction in shoulder dystocia with induction of labor, there is no proven benefit of reduction to the rate of BRACHIAL PLEXUS INJURY, which is damage to the network of nerves that send signals from the spine to the shoulder, arm and hand of the baby.
Actors: benefit, reduction, shoulder dystocia, induction, labor, BRACHIAL PLEXUS INJURY, damage, network, nerves, spine, shoulder, arm, hand, baby
Natural object. network of nerves
Done to: signals
Where: from the spine to the shoulder, arm and hand of the baby
general · form conclusions
Infinitive. to draw
Past. drew
Past participle. drawn
Gerund. drawing
BRACHIAL PLEXUS INJURY is such a rare event that we can’t draw firm conclusions based on current studies.
Actors: BRACHIAL PLEXUS INJURY, rare event, we, conclusions, current studies
Group. we
Done to: firm conclusions
Because of: based on current studies
biological · receive or obtain
Infinitive. to get
Past. got
Past participle. gotten
Gerund. getting
There is also no proven benefit of reduction in signs of NEONATAL ASPHYXIA, which is when the baby does not get enough oxygen during birth.
Actors: benefit, reduction, signs, NEONATAL ASPHYXIA, baby, oxygen, birth
Living thing. baby
Done to: enough oxygen
During: birth
general · prove to be
Infinitive. to tun out
Past. tuned out
Past participle. tun out
Gerund. tunning out
Suspected large babies may tun out to be smaller than expected at delivery, which means parents might be worried unnecessarily and might undergo induction of labor without any benefit.
Actors: large babies, delivery, parents, induction, labor, benefit
Living thing. Suspected large babies
Done to: to be smaller than expected at delivery
general · anticipate
Infinitive. to expect
Past. expected
Past participle. expected
Gerund. expecting
Suspected large babies may tun out to be smaller than expected at delivery, which means parents might be worried unnecessarily and might undergo induction of labor without any benefit.
Actors: large babies, delivery, parents, induction, labor, benefit
Done to: large babies
emotional · cause anxiety
Infinitive. to worry
Past. worried
Past participle. worried
Gerund. worrying
Suspected large babies may tun out to be smaller than expected at delivery, which means parents might be worried unnecessarily and might undergo induction of labor without any benefit.
Actors: large babies, delivery, parents, induction, labor, benefit
Done to: parents
How: unnecessarily
This may worry parents unnecessarily.
Actors: parents
Done to: parents
How: unnecessarily
medical · experience or be subjected to
Infinitive. to undergo
Past. underwent
Past participle. undergone
Gerund. undergoing
Suspected large babies may tun out to be smaller than expected at delivery, which means parents might be worried unnecessarily and might undergo induction of labor without any benefit.
Actors: large babies, delivery, parents, induction, labor, benefit
Individual. parents
Done to: induction of labor
general · require a duration
Infinitive. to take
Past. took
Past participle. taken
Gerund. taking
Induction of labor often takes longer than spontaneous labor at term.
Actors: Induction, labor, spontaneous labor, term
Done to: longer than spontaneous labor at term
These medications can be inserted into the vagina or taken by mouth.
Actors: medications, vagina, mouth
Done to: These medications
Where: by mouth
general · make greater in size or degree
Infinitive. to increase
Past. increased
Past participle. increased
Gerund. increasing
It might increase the risk of INSTRUMENTED DELIVERY (vaginal birth assisted by vacuum or forceps) and CESAREAN DELIVERY.
Actors: risk, INSTRUMENTED DELIVERY, vaginal birth, vacuum, forceps, CESAREAN DELIVERY
Group. Induction of labor
Done to: the risk of INSTRUMENTED DELIVERY and CESAREAN DELIVERY
High birthweight babies are at higher risk of sustaining injuries at the birth; risks of shoulder dystocia, fracture and brachial plexus injury are increased.
Actors: High birthweight babies, risk, injuries, birth, shoulder dystocia, fracture, brachial plexus injury
Done to: risks of shoulder dystocia, fracture and brachial plexus injury
Observational studies cast doubts on the effectiveness of such a policy and have suggested that induction increases the risk of caesarean section without reducing birth injury.
Actors: Observational studies, doubts, effectiveness, policy, induction, risk, caesarean section, birth injury
Group. induction
Done to: the risk of caesarean section
Some prostaglandins are not used if you have had a previous cesarean birth or other uterine surgery to avoid increasing the possible risk of uterine rupture.
Actors: prostaglandins, cesarean birth, uterine surgery, risk, uterine rupture
Done to: the possible risk of uterine rupture
medical · help with instruments
Infinitive. to assist
Past. assisted
Past participle. assisted
Gerund. assisting
It might increase the risk of INSTRUMENTED DELIVERY (vaginal birth assisted by vacuum or forceps) and CESAREAN DELIVERY.
Actors: risk, INSTRUMENTED DELIVERY, vaginal birth, vacuum, forceps, CESAREAN DELIVERY
Done to: vaginal birth
How: by vacuum or forceps
general · have an opinion or tactile sensation
Infinitive. to feel
Past. felt
Past participle. felt
Gerund. feeling
Although some parents and doctors may feel the existing evidence is sufficient to justify inducing labor, others may disagree.
Actors: parents, doctors, evidence, labor, others
Group. some parents and doctors
Done to: the existing evidence is sufficient to justify inducing labor
Clinical estimations of fetal weight are based on feeling the uterus and measuring the height of the fundus of the uterus.
Actors: Clinical estimations, fetal weight, uterus, height, fundus
Done to: the uterus
general · show to be right or reasonable
Infinitive. to justify
Past. justified
Past participle. justified
Gerund. justifying
Although some parents and doctors may feel the existing evidence is sufficient to justify inducing labor, others may disagree.
Actors: parents, doctors, evidence, labor, others
Done to: inducing labor
general · have a different opinion
Infinitive. to disagree
Past. disagreed
Past participle. disagreed
Gerund. disagreeing
Although some parents and doctors may feel the existing evidence is sufficient to justify inducing labor, others may disagree.
Actors: parents, doctors, evidence, labor, others
Group. others
general · discover or determine
Infinitive. to find out
Past. found out
Past participle. found out
Gerund. finding out
Further high-quality studies are needed to find out what is the best time to induce labor towards the end of pregnancy and how to improve the accuracy in diagnosing macrosomia.
Actors: high-quality studies, time, labor, pregnancy
Done to: what is the best time to induce labor towards the end of pregnancy and how to improve the accuracy in diagnosing macrosomia
general · make better
Infinitive. to improve
Past. improved
Past participle. improved
Gerund. improving
Further high-quality studies are needed to find out what is the best time to induce labor towards the end of pregnancy and how to improve the accuracy in diagnosing macrosomia.
Actors: high-quality studies, time, labor, pregnancy
Done to: the accuracy in diagnosing macrosomia
medical · identify a medical condition
Infinitive. to diagnose
Past. diagnosed
Past participle. diagnosed
Gerund. diagnosing
Further high-quality studies are needed to find out what is the best time to induce labor towards the end of pregnancy and how to improve the accuracy in diagnosing macrosomia.
Actors: high-quality studies, time, labor, pregnancy
Done to: macrosomia
general · state the meaning of
Infinitive. to define
Past. defined
Past participle. defined
Gerund. defining
Macrosomia is usually defined as a birthweight above 4000 g, although sometimes a higher cut-off of 4500 g is used.
Actors: Macrosomia, birthweight, 4000 g, higher cut-off, 4500 g
Done to: Macrosomia
Large-for-gestational-age fetuses are usually defined as those with a birthweight above the 90th percentile.
Actors: Large-for-gestational-age fetuses, birthweight, 90th percentile
Done to: Large-for-gestational-age fetuses
general · recognize or establish
Infinitive. to identify
Past. identified
Past participle. identified
Gerund. identifying
Weighing the infant after the birth is the only accurate way to identify macrosomia.
Actors: infant, birth, macrosomia
Done to: macrosomia
medical · determine the weight
Infinitive. to weigh
Past. weighed
Past participle. weighed
Gerund. weighing
Weighing the infant after the birth is the only accurate way to identify macrosomia.
Actors: infant, birth, macrosomia
Done to: the infant
At time: after the birth
medical · find the size or height
Infinitive. to measure
Past. measured
Past participle. measured
Gerund. measuring
Clinical estimations of fetal weight are based on feeling the uterus and measuring the height of the fundus of the uterus.
Actors: Clinical estimations, fetal weight, uterus, height, fundus
Done to: the height of the fundus of the uterus
general · verify the truth of
Infinitive. to confirm
Past. confirmed
Past participle. confirmed
Gerund. confirming
Ultrasound scanning is also not accurate later in the pregnancy, so suspected large babies may not be confirmed at delivery.
Actors: Ultrasound scanning, pregnancy, large babies, delivery
Done to: suspected large babies
At time: at delivery
general · influence or impact
Infinitive. to affect
Past. affected
Past participle. affected
Gerund. affecting
Approximately 10% of pregnancies are affected by macrosomia, although estimates range from 3% to 15% in different settings.
Actors: pregnancies, macrosomia, estimates, settings
Done to: Approximately 10% of pregnancies
general · vary within limits
Infinitive. to range
Past. ranged
Past participle. ranged
Gerund. ranging
Approximately 10% of pregnancies are affected by macrosomia, although estimates range from 3% to 15% in different settings.
Actors: pregnancies, macrosomia, estimates, settings
Done to: from 3% to 15%
general · provide or bestow
Infinitive. to give
Past. gave
Past participle. given
Gerund. giving
Risk factors for giving birth to a large birthweight infant include a previous history of macrosomia, maternal obesity, maternal weight gain during pregnancy, multiparity and male fetus.
Actors: Risk factors, birth, large birthweight infant, history, macrosomia, maternal obesity, maternal weight gain, pregnancy, multiparity, male fetus
Done to: birth to a large birthweight infant
With this scoring system, a number ranging from 0 to 13 is given to rate the condition of the cervix.
Actors: scoring system, number, condition, cervix
Done to: a number ranging from 0 to 13
If you and your pregnancy are doing well and the amniotic sac has not ruptured, you may be given the option to go home.
Actors: you, pregnancy, amniotic sac, option, home
Done to: you
In order to: go home
general · comprise or contain
Infinitive. to include
Past. included
Past participle. included
Gerund. including
Risk factors for giving birth to a large birthweight infant include a previous history of macrosomia, maternal obesity, maternal weight gain during pregnancy, multiparity and male fetus.
Actors: Risk factors, birth, large birthweight infant, history, macrosomia, maternal obesity, maternal weight gain, pregnancy, multiparity, male fetus
Done to: a previous history of macrosomia, maternal obesity, maternal weight gain during pregnancy, multiparity and male fetus
Other risks of labor induction may include:
Actors: Other risks, labor induction
Done to: Other risks of labor induction
Although most cesarean births are safe, there may be additional risks for you, including:
Actors: cesarean births, risks, you
Done to: additional risks for you
general · connect or link
Infinitive. to associate
Past. associated
Past participle. associated
Gerund. associating
Macrosomia is associated with a prolonged labor and maternal trauma along with a higher risk of birth injuries for the infant and longer-term adverse consequences.
Actors: Macrosomia, prolonged labor, maternal trauma, higher risk, birth injuries, consequences
Done to: Macrosomia
medical · undergo or experience an injury
Infinitive. to sustain
Past. sustained
Past participle. sustained
Gerund. sustaining
High birthweight babies are at higher risk of sustaining injuries at the birth; risks of shoulder dystocia, fracture and brachial plexus injury are increased.
Actors: High birthweight babies, risk, injuries, birth, shoulder dystocia, fracture, brachial plexus injury
Living thing. High birthweight babies
Done to: injuries
At time: at the birth
general · raise or increase
Infinitive. to elevate
Past. elevated
Past participle. elevated
Gerund. elevating
There is an increased risk of fetal death and neonatal complications, and the risks of diabetes and cardiovascular disease in childhood and adult life are also elevated.
Actors: risk, fetal death, neonatal complications, risks, diabetes, cardiovascular disease, childhood, adult life
Done to: the risks of diabetes and cardiovascular disease in childhood and adult life
general · imply or propose
Infinitive. to suggest
Past. suggested
Past participle. suggested
Gerund. suggesting
Observational studies cast doubts on the effectiveness of such a policy and have suggested that induction increases the risk of caesarean section without reducing birth injury.
Actors: Observational studies, doubts, effectiveness, policy, induction, risk, caesarean section, birth injury
Group. Observational studies
Done to: that induction increases the risk of caesarean section without reducing birth injury
general · make ready
Infinitive. to prepare
Past. prepared
Past participle. prepared
Gerund. preparing
To prepare for labor and delivery, the cervix begins to soften (ripen), thin out, and open.
Actors: labor, delivery, cervix
Done to: labor and delivery
general · start
Infinitive. to begin
Past. began
Past participle. begun
Gerund. beginning
To prepare for labor and delivery, the cervix begins to soften (ripen), thin out, and open.
Actors: labor, delivery, cervix
Done to: to soften, thin out, and open
These changes usually start a few weeks before labor begins.
Actors: changes, labor
Group. labor
medical · make softer
Infinitive. to soften
Past. softened
Past participle. softened
Gerund. softening
To prepare for labor and delivery, the cervix begins to soften (ripen), thin out, and open.
Actors: labor, delivery, cervix
Done to: the cervix
Ripening the cervix is a process that helps the cervix soften and thin out in preparation for labor.
Actors: Ripening, cervix, process, labor
Done to: the cervix
Medications or devices may be used to soften the cervix so it will stretch for labor.
Actors: Medications, devices, cervix, labor
Done to: the cervix
medical · make ripe
Infinitive. to ripen
Past. ripened
Past participle. ripened
Gerund. ripening
To prepare for labor and delivery, the cervix begins to soften (ripen), thin out, and open.
Actors: labor, delivery, cervix
Done to: the cervix
Ripening the cervix is a process that helps the cervix soften and thin out in preparation for labor.
Actors: Ripening, cervix, process, labor
Done to: the cervix
Prostaglandins are medications that can be used to ripen the cervix.
Actors: Prostaglandins, medications, cervix
Done to: the cervix
medical · become thinner
Infinitive. to thin out
Past. thinned out
Past participle. thinned out
Gerund. thinning out
To prepare for labor and delivery, the cervix begins to soften (ripen), thin out, and open.
Actors: labor, delivery, cervix
Done to: the cervix
Ripening the cervix is a process that helps the cervix soften and thin out in preparation for labor.
Actors: Ripening, cervix, process, labor
Done to: the cervix
medical · dilate or expand
Infinitive. to open
Past. opened
Past participle. opened
Gerund. opening
To prepare for labor and delivery, the cervix begins to soften (ripen), thin out, and open.
Actors: labor, delivery, cervix
Done to: the cervix
Then the balloon expands, which helps open the cervix.
Actors: balloon, cervix
Done to: the cervix
general · advance or proceed
Infinitive. to progress
Past. progressed
Past participle. progressed
Gerund. progressing
This means that labor cannot progress.
Actors: labor
Group. labor
medical · examine or inspect
Infinitive. to check
Past. checked
Past participle. checked
Gerund. checking
Your obstetrician–gynecologist (ob-gyn) will check to see if your cervix has started this change.
Actors: obstetrician–gynecologist, ob-gyn, cervix, change
Individual. obstetrician–gynecologist
Done to: to see if your cervix has started this change
general · evaluate or assign a score
Infinitive. to rate
Past. rated
Past participle. rated
Gerund. rating
The Bishop score may be used to rate the readiness of the cervix for labor.
Actors: Bishop score, readiness, cervix, labor
Done to: the readiness of the cervix for labor
With this scoring system, a number ranging from 0 to 13 is given to rate the condition of the cervix.
Actors: scoring system, number, condition, cervix
Done to: the condition of the cervix
general · extend between limits
Infinitive. to range
Past. ranged
Past participle. ranged
Gerund. ranging
With this scoring system, a number ranging from 0 to 13 is given to rate the condition of the cervix.
Actors: scoring system, number, condition, cervix
Done to: from 0 to 13
general · assist in an action
Infinitive. to help
Past. helped
Past participle. helped
Gerund. helping
Ripening the cervix is a process that helps the cervix soften and thin out in preparation for labor.
Actors: Ripening, cervix, process, labor
Done to: the cervix soften and thin out
Then the balloon expands, which helps open the cervix.
Actors: balloon, cervix
Done to: open the cervix
To help prevent these complications, the fetal heart rate and force of contractions may be electronically monitored during labor induction.
Actors: complications, fetal heart rate, force, contractions, labor induction
Done to: prevent these complications
medical · widen or extend
Infinitive. to stretch
Past. stretched
Past participle. stretched
Gerund. stretching
Medications or devices may be used to soften the cervix so it will stretch for labor.
Actors: Medications, devices, cervix, labor
Living thing. it
In order to: for labor
WHAT DEVICES ARE USED TO RIPEN AND DILATE THE CERVIX?
Actors: DEVICES, CERVIX
Done to: THE CERVIX
Laminaria are thin rods inserted into the cervix to dilate it.
Actors: Laminaria, thin rods, cervix
Done to: it
general · perform an action
Infinitive. to do
Past. did
Past participle. done
Gerund. doing
Ripening of the cervix can be done with medications or with special devices.
Actors: Ripening, cervix, medications, special devices
Done to: Ripening of the cervix
medical · put into something
Infinitive. to insert
Past. inserted
Past participle. inserted
Gerund. inserting
These medications can be inserted into the vagina or taken by mouth.
Actors: medications, vagina, mouth
Done to: These medications
Where: into the vagina
Laminaria are thin rods inserted into the cervix to dilate it.
Actors: Laminaria, thin rods, cervix
Done to: thin rods
Where: into the cervix
The tube is inserted through the vagina and into the opening of the cervix.
Actors: tube, vagina, opening, cervix
Done to: The tube
Where: through the vagina and into the opening of the cervix
general · become larger in size
Infinitive. to expand
Past. expanded
Past participle. expanded
Gerund. expanding
They are made of a substance that expands when it absorbs water.
Actors: substance, water
Made object. substance
Then the balloon expands, which helps open the cervix.
Actors: balloon, cervix
Made object. balloon
biological · take in liquid
Infinitive. to absorb
Past. absorbed
Past participle. absorbed
Gerund. absorbing
They are made of a substance that expands when it absorbs water.
Actors: substance, water
Made object. substance
Done to: water
medical · stimulate too much
Infinitive. to overstimulate
Past. overstimulated
Past participle. overstimulated
Gerund. overstimulating
One risk is that when oxytocin is used, the uterus may be overstimulated.
Actors: risk, oxytocin, uterus
Done to: the uterus
general · bring about an event or condition
Infinitive. to cause
Past. caused
Past participle. caused
Gerund. causing
This may cause the uterus to contract too often.
Actors: uterus
Done to: the uterus to contract too often
medical · tighten or shorten
Infinitive. to contract
Past. contracted
Past participle. contracted
Gerund. contracting
This may cause the uterus to contract too often.
Actors: uterus
Living thing. the uterus
Intensity: too often
general · result in
Infinitive. to lead
Past. led
Past participle. led
Gerund. leading
Too many contractions may lead to changes in the fetal heart rate.
Actors: contractions, changes, fetal heart rate
Done to: changes in the fetal heart rate
general · cease or halt
Infinitive. to stop
Past. stopped
Past participle. stopped
Gerund. stopping
If there are problems with the fetal heart rate, oxytocin may be reduced or stopped.
Actors: problems, fetal heart rate, oxytocin
Done to: oxytocin
medical · make steady or stable
Infinitive. to steady
Past. steadied
Past participle. steadied
Gerund. steadying
Other treatments may be needed to steady the fetal heart rate.
Actors: Other treatments, fetal heart rate
Done to: the fetal heart rate
medical · keep from happening
Infinitive. to prevent
Past. prevented
Past participle. prevented
Gerund. preventing
To help prevent these complications, the fetal heart rate and force of contractions may be electronically monitored during labor induction.
Actors: complications, fetal heart rate, force, contractions, labor induction
Done to: these complications
medical · observe over time
Infinitive. to monitor
Past. monitored
Past participle. monitored
Gerund. monitoring
To help prevent these complications, the fetal heart rate and force of contractions may be electronically monitored during labor induction.
Actors: complications, fetal heart rate, force, contractions, labor induction
Done to: the fetal heart rate and force of contractions
During: labor induction
How: electronically
general · arrange an appointment
Infinitive. to schedule
Past. scheduled
Past participle. scheduled
Gerund. scheduling
You can schedule another appointment to try induction again.
Actors: You, appointment, induction
Individual. You
Done to: another appointment
general · begin
Infinitive. to start
Past. started
Past participle. started
Gerund. starting
If your labor starts, you should go back to the hospital.
Actors: labor, you, hospital
Group. your labor
general · move or travel
Infinitive. to go
Past. went
Past participle. gone
Gerund. going
If you and your pregnancy are doing well and the amniotic sac has not ruptured, you may be given the option to go home.
Actors: you, pregnancy, amniotic sac, option, home
Individual. you
Where: home
If your labor starts, you should go back to the hospital.
Actors: labor, you, hospital
Individual. you
Where: back to the hospital
general · try to do something
Infinitive. to attempt
Past. attempted
Past participle. attempted
Gerund. attempting
If you or your baby is not doing well during or after attempting induction, a cesarean birth may be needed.
Actors: you, baby, induction, cesarean birth
Done to: induction
general · increase
Infinitive. to go up
Past. went up
Past participle. gone up
Gerund. going up
With each cesarean birth, the risk of serious placenta problems in future pregnancies goes up.
Actors: cesarean birth, risk, placenta problems, future pregnancies
Made object. the risk of serious placenta problems in future pregnancies
other · medical procedure
manMadeObject · pharmaceutical
other · procedure
other · clinical state
naturalObject · physiological process
naturalObject · organ
other · delivery method
other · medical state
individual · person
livingThing · organism
other · medical risk
other · medical state
other · medical condition
livingThing · infant
other · definition
other · measurement
manMadeObject · quantity
manMadeObject · quantity
livingThing · infants
other · method
other · medical condition
group · people
other · medical condition
naturalObject · body part
other · delivery method
other · statistical measure
other · medical condition
livingThing · infant
naturalObject · bone
other · medical outcome
other · medical condition
other · medical condition
naturalObject · anatomical network
naturalObject · body part
naturalObject · body part
naturalObject · body part
other · statistical frequency
other · research
other · medical condition
naturalObject · gas
other · calculation
livingThing · infants
other · medical event
group · people
other · medical outcome
other · medical process
other · time period
other · medical risk
other · delivery method
manMadeObject · medical instrument
manMadeObject · medical instrument
other · delivery method
group · people
other · research data
group · people
other · research
other · time point
other · metric
other · medical procedure
other · text
other · text
other · threshold
manMadeObject · quantity
livingThing · infants
other · statistical percentile
individual · person
livingThing · baby
other · measurement
other · measurement
naturalObject · body part
other · medical metric
manMadeObject · medical device
other · medical state
other · location
other · medical risk
livingThing · infant
other · medical history
other · medical condition
other · medical condition
other · medical state
livingThing · organism
other · medical condition
other · medical condition
other · medical outcome
group · people
livingThing · infants
other · medical procedure
other · medical condition
other · medical condition
other · medical condition
other · medical condition
other · medical condition
other · medical condition
other · life stage
other · life stage
other · goal
other · medical condition
other · probability
other · medical condition
other · medical procedure
other · research
other · skepticism
other · metric
other · medical policy
other · medical condition
naturalObject · organ
other · physiological change
individual · person
other · scoring system
other · system
manMadeObject · quantity
other · medical state
other · medical procedure
other · procedure
manMadeObject · medical device
manMadeObject · pharmaceutical
other · chemical form
naturalObject · chemical substance
livingThing · organism
naturalObject · body part
naturalObject · body part
other · delivery method
other · surgical procedure
other · medical condition
livingThing · natural material
manMadeObject · medical device
manMadeObject · material
naturalObject · liquid
manMadeObject · medical device
manMadeObject · medical device
other · location
naturalObject · body part
manMadeObject · medication
other · medical metric
other · medical treatment
other · medical condition
other · medical condition
naturalObject · biological fluid
naturalObject · organ
naturalObject · body part
other · medical condition
other · medical condition
other · measurement
naturalObject · organ
other · choice
other · location
other · schedule
organization · medical facility
other · medical condition
manMadeObject · medication
other · time period
other · medical consideration
other · influencing factor
livingThing · infants
D2 - S1 · present · positive · THE PROPOSED INTERVENTION
Labor induction is the use of medications or other methods to bring on (induce) labor.
D2 - S2 · present · positive · THE PROPOSED INTERVENTION
Labor is induced to stimulate contractions of the uterus in an effort to have a vaginal birth.
D2 - S3 · present · positive · THE PROPOSED INTERVENTION
Labor induction may be recommended if the health of the mother or fetus is at risk.
D2 - S4 · present · positive · THE PROPOSED INTERVENTION
Sometimes labor induction may be needed even if it means that the fetus will be born early.
D2 - S5 · present · positive · THE PROPOSED INTERVENTION
In these cases, the risks of continuing the pregnancy are judged to outweigh the risks of the fetus being born too early.
D2 - S6 · present · positive · THE REASON (CLINICAL INDICATION) FOR THIS INTERVENTION
MACROSOMIA refers to a baby who is very large at the time of birth.
D2 - S7 · present · positive · THE REASON (CLINICAL INDICATION) FOR THIS INTERVENTION
The clinical definition is birth weight over 4000 grams (8 pounds 13 ounces).
D2 - S8 · present · positive · THE REASON (CLINICAL INDICATION) FOR THIS INTERVENTION
Macrosomic babies can have difficult and occasionally traumatic births.
D2 - S9 · present · positive · THE REASON (CLINICAL INDICATION) FOR THIS INTERVENTION
One approach to try to reduce this trauma has been to induce labor early, so that we may deliver before the baby grows too big.
D2 - S10 · present · positive · POTENTIAL BENEFITS OF INDUCTION OF LABOR FOR SUSPECTED FETAL MACROSOMIA
In Macrosomic babies, induction of labor before term has been shown to reduce SHOULDER DYSTOCIA, which is when the baby's shoulder becomes stuck during vaginal delivery.
D2 - S11 · present · positive · POTENTIAL BENEFITS OF INDUCTION OF LABOR FOR SUSPECTED FETAL MACROSOMIA
There is also reduction in the rate of BONE FRACTURE in the newborn.
D2 - S12 · present · positive · POTENTIAL BENEFITS OF INDUCTION OF LABOR FOR SUSPECTED FETAL MACROSOMIA
However, when bone fractures occur, they are usually to the clavicle, which heals well without long-term consequences.
D2 - S13 · present · positive · POTENTIAL BENEFITS OF INDUCTION OF LABOR FOR SUSPECTED FETAL MACROSOMIA
Even though there is the benefit of reduction in shoulder dystocia with induction of labor, there is no proven benefit of reduction to the rate of BRACHIAL PLEXUS INJURY, which is damage to the network of nerves that send signals from the spine to the shoulder, arm and hand of the baby.
D2 - S14 · present · negative · POTENTIAL BENEFITS OF INDUCTION OF LABOR FOR SUSPECTED FETAL MACROSOMIA
BRACHIAL PLEXUS INJURY is such a rare event that we can’t draw firm conclusions based on current studies.
D2 - S15 · present · negative · POTENTIAL BENEFITS OF INDUCTION OF LABOR FOR SUSPECTED FETAL MACROSOMIA
There is also no proven benefit of reduction in signs of NEONATAL ASPHYXIA, which is when the baby does not get enough oxygen during birth.
D2 - S16 · present · negative · POTENTIAL RISKS OF INDUCTION OF LABOR FOR SUSPECTED FETAL MACROSOMIA
Estimation of the baby's weight is difficult before birth and is not very accurate.
D2 - S17 · present · positive · POTENTIAL RISKS OF INDUCTION OF LABOR FOR SUSPECTED FETAL MACROSOMIA
Suspected large babies may tun out to be smaller than expected at delivery, which means parents might be worried unnecessarily and might undergo induction of labor without any benefit.
D2 - S18 · present · positive · POTENTIAL RISKS OF INDUCTION OF LABOR FOR SUSPECTED FETAL MACROSOMIA
Induction of labor often takes longer than spontaneous labor at term.
D2 - S19 · present · positive · POTENTIAL RISKS OF INDUCTION OF LABOR FOR SUSPECTED FETAL MACROSOMIA
It might increase the risk of INSTRUMENTED DELIVERY (vaginal birth assisted by vacuum or forceps) and CESAREAN DELIVERY.
D2 - S20 · present · positive · POTENTIAL RISKS OF INDUCTION OF LABOR FOR SUSPECTED FETAL MACROSOMIA
Although some parents and doctors may feel the existing evidence is sufficient to justify inducing labor, others may disagree.
D2 - S21 · present · positive · POTENTIAL RISKS OF INDUCTION OF LABOR FOR SUSPECTED FETAL MACROSOMIA
Further high-quality studies are needed to find out what is the best time to induce labor towards the end of pregnancy and how to improve the accuracy in diagnosing macrosomia.
D2 - S22 · present · positive
Frequently asked Questions and Answers are as follows.
D2 - S23 · present · positive · Frequently asked Questions and Answers
WHAT IS MACROSOMIA?
D2 - S24 · present · positive · Frequently asked Questions and Answers
Macrosomia is usually defined as a birthweight above 4000 g, although sometimes a higher cut-off of 4500 g is used.
D2 - S25 · present · positive · Frequently asked Questions and Answers
Large-for-gestational-age fetuses are usually defined as those with a birthweight above the 90th percentile.
D2 - S26 · present · positive · Frequently asked Questions and Answers
HOW DO I KNOW MY BABY IS TOO BIG?
D2 - S27 · present · positive · Frequently asked Questions and Answers
Weighing the infant after the birth is the only accurate way to identify macrosomia.
D2 - S28 · present · negative · Frequently asked Questions and Answers
The estimation of the baby's weight is difficult before birth and not very accurate.
D2 - S29 · present · positive · Frequently asked Questions and Answers
Clinical estimations of fetal weight are based on feeling the uterus and measuring the height of the fundus of the uterus.
D2 - S30 · present · positive · Frequently asked Questions and Answers
Both are subject to considerable variation.
D2 - S31 · present · negative · Frequently asked Questions and Answers
Ultrasound scanning is also not accurate later in the pregnancy, so suspected large babies may not be confirmed at delivery.
D2 - S32 · present · positive · Frequently asked Questions and Answers
This may worry parents unnecessarily.
D2 - S33 · present · positive · Frequently asked Questions and Answers
HOW COMMON IS MACROSOMIA?
D2 - S34 · present · positive · Frequently asked Questions and Answers
Approximately 10% of pregnancies are affected by macrosomia, although estimates range from 3% to 15% in different settings.
D2 - S35 · present · positive · Frequently asked Questions and Answers
HOW DO I KNOW IF I AM AT RISK FOR MACROSOMIA?
D2 - S36 · present · positive · Frequently asked Questions and Answers
Risk factors for giving birth to a large birthweight infant include a previous history of macrosomia, maternal obesity, maternal weight gain during pregnancy, multiparity and male fetus.
D2 - S37 · present · positive · Frequently asked Questions and Answers
WHAT ARE THE RISKS OF MACROSOMIA FOR ME AND MY BABY?
D2 - S38 · present · positive · Frequently asked Questions and Answers
Macrosomia is associated with a prolonged labor and maternal trauma along with a higher risk of birth injuries for the infant and longer-term adverse consequences.
D2 - S39 · present · positive · Frequently asked Questions and Answers
Women with large-for-dates fetuses are more likely to have labor augmentation and caesarean section, more serious perineal trauma, and more severe morbidity.
D2 - S40 · present · positive · Frequently asked Questions and Answers
High birthweight babies are at higher risk of sustaining injuries at the birth; risks of shoulder dystocia, fracture and brachial plexus injury are increased.
D2 - S41 · present · positive · Frequently asked Questions and Answers
There is an increased risk of fetal death and neonatal complications, and the risks of diabetes and cardiovascular disease in childhood and adult life are also elevated.
D2 - S42 · present · positive · Frequently asked Questions and Answers
HOW DOES INDUCTION OF LABOR HELP WITH MACROSOMIA?
D2 - S43 · present · positive · Frequently asked Questions and Answers
The purpose of labor induction at or shortly before term (37 to 40 weeks) in case of suspected fetal macrosomia is to reduce the likelihood of a difficult birth, possibly resulting in maternal or perinatal morbidity.
D2 - S44 · present · positive · Frequently asked Questions and Answers
In particular, the risk of shoulder dystocia and the associated risk of neonatal trauma might be reduced by the intervention.
D2 - S45 · present · positive · Frequently asked Questions and Answers
Observational studies cast doubts on the effectiveness of such a policy and have suggested that induction increases the risk of caesarean section without reducing birth injury.
D2 - S46 · present · positive · Frequently asked Questions and Answers
HOW DOES LABOR INDUCTION WORK?
D2 - S47 · present · positive · Frequently asked Questions and Answers
Labor induction is the use of medications or other methods to bring on (induce) labor.
D2 - S48 · present · positive · Frequently asked Questions and Answers
To prepare for labor and delivery, the cervix begins to soften (ripen), thin out, and open.
D2 - S49 · present · positive · Frequently asked Questions and Answers
These changes usually start a few weeks before labor begins.
D2 - S50 · present · negative · Frequently asked Questions and Answers
Sometimes when labor is going to be induced, the cervix is not yet "ripe" or soft.
D2 - S51 · present · negative · Frequently asked Questions and Answers
This means that labor cannot progress.
D2 - S52 · future · positive · Frequently asked Questions and Answers
Your obstetrician–gynecologist (ob-gyn) will check to see if your cervix has started this change.
D2 - S53 · present · positive · Frequently asked Questions and Answers
The Bishop score may be used to rate the readiness of the cervix for labor.
D2 - S54 · present · positive · Frequently asked Questions and Answers
With this scoring system, a number ranging from 0 to 13 is given to rate the condition of the cervix.
D2 - S55 · present · negative · Frequently asked Questions and Answers
A Bishop score of less than 6 means that your cervix may not be ready for labor.
D2 - S56 · present · positive · Frequently asked Questions and Answers
WHAT IS RIPENING THE CERVIX
D2 - S57 · present · positive · Frequently asked Questions and Answers
Ripening the cervix is a process that helps the cervix soften and thin out in preparation for labor.
D2 - S58 · present · positive · Frequently asked Questions and Answers
Medications or devices may be used to soften the cervix so it will stretch for labor.
D2 - S59 · present · positive · Frequently asked Questions and Answers
Ripening of the cervix can be done with medications or with special devices.
D2 - S60 · present · positive · Frequently asked Questions and Answers
WHAT MEDICATIONS ARE USED TO RIPEN THE CERVIX?
D2 - S61 · present · positive · Frequently asked Questions and Answers
Prostaglandins are medications that can be used to ripen the cervix.
D2 - S62 · present · positive · Frequently asked Questions and Answers
They are forms of chemicals made naturally by the body.
D2 - S63 · present · positive · Frequently asked Questions and Answers
These medications can be inserted into the vagina or taken by mouth.
D2 - S64 · present · negative · Frequently asked Questions and Answers
Some prostaglandins are not used if you have had a previous cesarean birth or other uterine surgery to avoid increasing the possible risk of uterine rupture.
D2 - S65 · present · positive · Frequently asked Questions and Answers
WHAT DEVICES ARE USED TO RIPEN AND DILATE THE CERVIX?
D2 - S66 · present · positive · Frequently asked Questions and Answers
Laminaria are thin rods inserted into the cervix to dilate it.
D2 - S67 · present · positive · Frequently asked Questions and Answers
They are made of a substance that expands when it absorbs water.
D2 - S68 · present · positive · Frequently asked Questions and Answers
A catheter with an inflatable balloon on the end.
D2 - S69 · present · positive · Frequently asked Questions and Answers
The tube is inserted through the vagina and into the opening of the cervix.
D2 - S70 · present · positive · Frequently asked Questions and Answers
Then the balloon expands, which helps open the cervix.
D2 - S71 · present · positive · Frequently asked Questions and Answers
WHAT ARE THE RISKS OF LABOR INDUCTION?
D2 - S72 · present · positive · Frequently asked Questions and Answers
One risk is that when oxytocin is used, the uterus may be overstimulated.
D2 - S73 · present · positive · Frequently asked Questions and Answers
This may cause the uterus to contract too often.
D2 - S74 · present · positive · Frequently asked Questions and Answers
Too many contractions may lead to changes in the fetal heart rate.
D2 - S75 · present · positive · Frequently asked Questions and Answers
If there are problems with the fetal heart rate, oxytocin may be reduced or stopped.
D2 - S76 · present · positive · Frequently asked Questions and Answers
Other treatments may be needed to steady the fetal heart rate.
D2 - S77 · present · positive · Frequently asked Questions and Answers
Other risks of labor induction may include:
D2 - S78 · present · positive · Frequently asked Questions and Answers
• chorioamnionitis, an infection of the amniotic fluid, placenta, or membranes
D2 - S79 · present · positive · Frequently asked Questions and Answers
• infection of the baby
D2 - S80 · present · positive · Frequently asked Questions and Answers
• rupture of the uterus
D2 - S81 · past · positive · Frequently asked Questions and Answers
Medical problems that were present before pregnancy or occurred during pregnancy may contribute to these complications.
D2 - S82 · present · positive · Frequently asked Questions and Answers
To help prevent these complications, the fetal heart rate and force of contractions may be electronically monitored during labor induction.
D2 - S83 · present · negative · Frequently asked Questions and Answers
WHAT IF LABOR INDUCTION DOES NOT WORK?
D2 - S84 · present · negative · Frequently asked Questions and Answers
Sometimes labor induction doesn't work.
D2 - S85 · present · positive · Frequently asked Questions and Answers
If you and your pregnancy are doing well and the amniotic sac has not ruptured, you may be given the option to go home.
D2 - S86 · present · positive · Frequently asked Questions and Answers
You can schedule another appointment to try induction again.
D2 - S87 · present · positive · Frequently asked Questions and Answers
If your labor starts, you should go back to the hospital.
D2 - S88 · present · negative · Frequently asked Questions and Answers
If you or your baby is not doing well during or after attempting induction, a cesarean birth may be needed.
D2 - S89 · present · positive · Frequently asked Questions and Answers
Although most cesarean births are safe, there may be additional risks for you, including:
D2 - S90 · present · positive · Frequently asked Questions and Answers
• infection
D2 - S91 · present · positive · Frequently asked Questions and Answers
• hemorrhage
D2 - S92 · present · positive · Frequently asked Questions and Answers
• complications from anesthesia
D2 - S93 · present · positive · Frequently asked Questions and Answers
The recovery time after a cesarean birth is usually longer than for a vaginal birth.
D2 - S94 · present · positive · Frequently asked Questions and Answers
There are also considerations for future pregnancies.
D2 - S95 · present · positive · Frequently asked Questions and Answers
With each cesarean birth, the risk of serious placenta problems in future pregnancies goes up.
D2 - S96 · present · positive · Frequently asked Questions and Answers
In addition, the number of cesarean births you have had is a major factor in how you will give birth to any future babies.
1- THE PROPOSED INTERVENTION Labor induction is the use of medications or other methods to bring on (induce) labor. Labor is induced to stimulate contractions of the uterus in an effort to have a vaginal birth. Labor induction may be recommended if the health of the mother or fetus is at risk. Sometimes labor induction may be needed even if it means that the fetus will be born early. In these cases, the risks of continuing the pregnancy are judged to outweigh the risks of the fetus being born too early. 2- THE REASON (CLINICAL INDICATION) FOR THIS INTERVENTION MACROSOMIA refers to a baby who is very large at the time of birth. The clinical definition is birth weight over 4000 grams (8 pounds 13 ounces). Macrosomic babies can have difficult and occasionally traumatic births. One approach to try to reduce this trauma has been to induce labor early, so that we may deliver before the baby grows too big. 3- POTENTIAL BENEFITS OF INDUCTION OF LABOR FOR SUSPECTED FETAL MACROSOMIA In Macrosomic babies, induction of labor before term has been shown to reduce SHOULDER DYSTOCIA, which is when the baby's shoulder becomes stuck during vaginal delivery. There is also reduction in the rate of BONE FRACTURE in the newborn. However, when bone fractures occur, they are usually to the clavicle, which heals well without long-term consequences. Even though there is the benefit of reduction in shoulder dystocia with induction of labor, there is no proven benefit of reduction to the rate of BRACHIAL PLEXUS INJURY, which is damage to the network of nerves that send signals from the spine to the shoulder, arm and hand of the baby. BRACHIAL PLEXUS INJURY is such a rare event that we can’t draw firm conclusions based on current studies. There is also no proven benefit of reduction in signs of NEONATAL ASPHYXIA, which is when the baby does not get enough oxygen during birth. 4- POTENTIAL RISKS OF INDUCTION OF LABOR FOR SUSPECTED FETAL MACROSOMIA Estimation of the baby's weight is difficult before birth and is not very accurate. Suspected large babies may tun out to be smaller than expected at delivery, which means parents might be worried unnecessarily and might undergo induction of labor without any benefit. Induction of labor often takes longer than spontaneous labor at term. It might increase the risk of INSTRUMENTED DELIVERY (vaginal birth assisted by vacuum or forceps) and CESAREAN DELIVERY. Although some parents and doctors may feel the existing evidence is sufficient to justify inducing labor, others may disagree. Further high-quality studies are needed to find out what is the best time to induce labor towards the end of pregnancy and how to improve the accuracy in diagnosing macrosomia. 5- Frequently asked Questions and Answers are as follows. WHAT IS MACROSOMIA? Macrosomia is usually defined as a birthweight above 4000 g, although sometimes a higher cut-off of 4500 g is used (Delpapa 1991; Chatfield 2001: Ju 2009). Large-for-gestational-age fetuses are usually defined as those with a birthweight above the 90th percentile. HOW DO I KNOW MY BABY IS TOO BIG? Weighing the infant after the birth is the only accurate way to identify macrosomia. The estimation of the baby's weight is difficult before birth and not very accurate. Clinical estimations of fetal weight are based on feeling the uterus and measuring the height of the fundus of the uterus. Both are subject to considerable variation. Ultrasound scanning is also not accurate later in the pregnancy, so suspected large babies may not be confirmed at delivery. This may worry parents unnecessarily. HOW COMMON IS MACROSOMIA? Approximately 10% of pregnancies are affected by macrosomia, although estimates range from 3% to 15% in different settings (Chatfield 2001; Mohammadbeigi 2013). HOW DO I KNOW IF I AM AT RISK FOR MACROSOMIA? Risk factors for giving birth to a large birthweight infant include a previous history of macrosomia, maternal obesity, maternal weight gain during pregnancy, multiparity and male fetus (Berard 1998; Cameron 2014; Gaudet 2014). WHAT ARE THE RISKS OF MACROSOMIA FOR ME AND MY BABY? Macrosomia is associated with a prolonged labor and maternal trauma along with a higher risk of birth injuries for the infant and longer-term adverse consequences (Ju 2009; Chatfield 2001; Mohammadbeigi 2013; Perlow 1996). Women with large-for-dates fetuses are more likely to have labor augmentation and caesarean section, more serious perineal trauma, and more severe morbidity. High birthweight babies are at higher risk of sustaining injuries at the birth; risks of shoulder dystocia, fracture and brachial plexus injury are increased. There is an increased risk of fetal death and neonatal complications, and the risks of diabetes and cardiovascular disease in childhood and adult life are also elevated. HOW DOES INDUCTION OF LABOR HELP WITH MACROSOMIA? The purpose of labor induction at or shortly before term (37 to 40 weeks) in case of suspected fetal macrosomia is to reduce the likelihood of a difficult birth, possibly resulting in maternal or perinatal morbidity (Perlow 1996). In particular, the risk of shoulder dystocia and the associated risk of neonatal trauma might be reduced by the intervention. Observational studies cast doubts on the effectiveness of such a policy (Friesen 1995; Weeks 1995) and have suggested that induction increases the risk of caesarean section without reducing birth injury. HOW DOES LABOR INDUCTION WORK? Labor induction is the use of medications or other methods to bring on (induce) labor. To prepare for labor and delivery, the cervix begins to soften (ripen), thin out, and open. These changes usually start a few weeks before labor begins. Sometimes when labor is going to be induced, the cervix is not yet "ripe" or soft. This means that labor cannot progress. Your obstetrician–gynecologist (ob-gyn) will check to see if your cervix has started this change. The Bishop score may be used to rate the readiness of the cervix for labor. With this scoring system, a number ranging from 0 to 13 is given to rate the condition of the cervix. A Bishop score of less than 6 means that your cervix may not be ready for labor. WHAT IS RIPENING THE CERVIX Ripening the cervix is a process that helps the cervix soften and thin out in preparation for labor. Medications or devices may be used to soften the cervix so it will stretch (dilate) for labor. Ripening of the cervix can be done with medications or with special devices. WHAT MEDICATIONS ARE USED TO RIPEN THE CERVIX? Prostaglandins are medications that can be used to ripen the cervix. They are forms of chemicals made naturally by the body. These medications can be inserted into the vagina or taken by mouth. Some prostaglandins are not used if you have had a previous cesarean birth or other uterine surgery to avoid increasing the possible risk of uterine rupture (tearing). WHAT DEVICES ARE USED TO RIPEN AND DILATE THE CERVIX? Laminaria are thin rods inserted into the cervix to dilate it. They are made of a substance that expands when it absorbs water. A catheter (small tube) with an inflatable balloon on the end. The tube is inserted through the vagina and into the opening of the cervix. Then the balloon expands, which helps open the cervix. WHAT ARE THE RISKS OF LABOR INDUCTION? One risk is that when oxytocin is used, the uterus may be overstimulated. This may cause the uterus to contract too often. Too many contractions may lead to changes in the fetal heart rate. If there are problems with the fetal heart rate, oxytocin may be reduced or stopped. Other treatments may be needed to steady the fetal heart rate. Other risks of labor induction may include: • chorioamnionitis, an infection of the amniotic fluid, placenta, or membranes • infection of the baby • rupture of the uterus (this is rare) Medical problems that were present before pregnancy or occurred during pregnancy may contribute to these complications. To help prevent these complications, the fetal heart rate and force of contractions may be electronically monitored during labor induction. WHAT IF LABOR INDUCTION DOES NOT WORK? Sometimes labor induction doesn't work. If you and your pregnancy are doing well and the amniotic sac has not ruptured, you may be given the option to go home. You can schedule another appointment to try induction again. If your labor starts, you should go back to the hospital. If you or your baby is not doing well during or after attempting induction, a cesarean birth may be needed. Although most cesarean births are safe, there may be additional risks for you, including: • infection • hemorrhage (heavy bleeding) • complications from anesthesia The recovery time after a cesarean birth is usually longer than for a vaginal birth. There are also considerations for future pregnancies. With each cesarean birth, the risk of serious placenta problems in future pregnancies goes up. In addition, the number of cesarean births you have had is a major factor in how you will give birth to any future babies.