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02 September 2021, Volume 37 Issue 9 Previous Issue    Next Issue

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Current status of cervical ripening. XU Qiao，ZHOU Wei 2021, 37(9): 897-900.  DOI: 10.19538/j.fk2021090103 Abstract ( )   Successful induction of labor mainly depends on cervical ripening.  Safe and effective cervical ripening intervention can improve the rate of vaginal delivery and reduce complications in patients with unfavorable cervical conditions. In clinical practice cervical ripening should be performed under criteria and guidelines. In addition，maternal individual characters also need be considered to decide the specific plan，which is important to insure health of mothers and infant.At presents，the way of cervical ripening sometimes is selected according to what obstetricians like，for lack of knowledge about mechanisms.  Indications，contraindications and precautions can be better learned by learning about the mechanism of various methods of cervical ripening in order to eradicate adverse outcomes of mothers and infants caused by improper intervention.

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At 39 weeks of gestation，induction of labor or expectant management. BAI Yu-xiang，QI Hong-bo 2021, 37(9): 900-903.  DOI: 10.19538/j.fk2021090104 Abstract ( )   The ARRIVE research and subsequent researches has demonstrated the safety of induction labor in low-risk nulliparous and multiparous women at 39 weeks of gestation with decreased cesarean deliveries and low risks of perinatal outcomes. Does this mean that the time of delivery at 39 weeks of gestation has come? This article will focus on this problem.

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Induction for premature rupture of membrane. HE Jing，CAI Shu-ping 2021, 37(9): 903-907.  DOI: 10.19538/j.fk2021090105 Abstract ( )   Considering the causes and potential risks of membrane rupture，induction of near-term and full-term premature rupture of membranes is of more positive significance than expected treatment. All PROM patients without contraindication to vaginal delivery may be considered for induction of labor within 2 to 12 hours or 24 hours after rupture of the membrane. Oxytocin，misoprostol，denoprostol，and mechanical methods can be used for induction of labor in patients with PROM. However，attention should be paid to the exclusion of infection，pelvic imbalance and other unsuitable conditions for vaginal delivery before induction，and more appropriate methods should be selected according to the patient's birth times and cervical Bishop score. In the process of induction of labor，we should also pay attention to the dynamic assessment of maternal and fetal conditions and progress of labor，and conduct individualized management.

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Standardized application of oxytocin in induction and augmentation of labor. RU Ping，LIU Ming 2021, 37(9): 907-911.  DOI: 10.19538/j.fk2021090106 Abstract ( )   Oxytocin plays an irreplaceable role in reducing cesarean delivery rates and shortening labor processing，which is widely used in clinic. However，the unregulated clinical application of oxytocin is associated with increased risks of adverse pregnancy-related complications and outcomes for both mothers and infants. To date，there has been no agreement about the dosage，treatment timing，frequency of application. Therefore，it will help clinicians to ensure medication safety that finding greatest medication use，treatment timing and dosage，specifying management，enhancing surveillance.

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Clinical application of artificial rupture of membrane. XIAO Mei，ZHAO Lei 2021, 37(9): 911-914.  DOI: 10.19538/j.fk2021090107 Abstract ( )   Artificial rupture of membrane（ARM）is an old method of induced labor. With the development of medicine，especially，obstetric workers' research on big data of labor process and new labor process in recent years，there has been some new knowledge on the application of ARM in obstetric clinical work. There are clear suggestions and recommendations on the related consensus and guidelines. The paper reviews the relevant literature and discusses the feasibility of ARM in obstetrics clinical work based on clinical practice.

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Timing and method of induced labour in twin pregnancy. LI Jia-xin，ZHAO Yang-yu 2021, 37(9): 914-917.  DOI: 10.19538/j.fk2021090108 Abstract ( )   Twin pregnancy belongs to the category of high-risk pregnancy，and both its preterm birth rate and cesarean section rate are higher than singleton pregnancy. At present，domestic and foreign studies on the timing and method for induction of labour in twin pregnancy are very limited and controversial. This article discusses the implementation of induction by the evaluation of effectiveness and safety，the selection of timing and method and the management of intrapartum in twin pregnancy in order to provide the basis for the standardized management of vaginal delivery in twin pregnancy.

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Clinical evaluation and induction of labor in macrosomia. MA Rui-lin，MAO Yan，ZHAO Yin. 2021, 37(9): 918-921.  DOI: 10.19538/j.fk2021090109 Abstract ( )   Macrosomia is one of the common fetal complications in obstetrics. The associated high risk factors include high pre-pregnancy body mass index （BMI），excessive increase of body weight during pregnancy and gestational diabetes mellitus. Macrosomia raises the rate of cesarean section. The incidence of severe perineal tear，shoulder dystocia，brachial plexus injury，neonatal asphyxia，death and other adverse maternal and infant outcomes increases，too. Accurate clinical evaluation of macrosomia and timely termination of pregnancy may avoid complications and improve maternal and infant outcomes. The clinical and ultrasonic evaluation and prediction methods of macrosomia，the intervention methods of induced labor and pregnancy outcome were discussed in the current paper.

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Induction of labor in trial of labor after cesarean section. MA Jun-nan，ZHU Tian-ying，MA Run-mei 2021, 37(9): 921-925.  DOI: 10.19538/j.fk2021090110 Abstract ( )   For women with a previous lower segment cesarean section，when indicated to induce labor for maternal or fetal reasons，and without contraindication，a trial of labor after cesarean（TOLAC）can be recommended. The risks and benefits of expectant onset of spontaneous labor，induction of labor and elective repeat cesarean section（ERCS）should be carefully evaluated. The patient and her family members should be encouraged to join the more detailed discussion with the doctors to make the final decision regarding the mode of delivery，or induction of labor，individually.

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Induction of labor for abnormal amniotic fluid volume. ZHANG Li-zi，CHEN Dun-jin 2021, 37(9): 925-927.  DOI: 10.19538/j.fk2021090111 Abstract ( )   During normal pregnancy，the production and absorption of amniotic fluid is in dynamic balance. Abnormal amniotic fluid volume is closely related to maternal and fetal complications，which directly endangers the safety of perinatal infants. According to the etiology of abnormal amniotic fluid volume，gestational age，the severity of maternal symptoms and the conditions of the fetus in utero，adopting appropriate methods of labor induction based on indications is of great significance to improve the outcome of perinatal infants.