Induction of labour (IOL) is the artificial initiation of uterine contraction prior to their spontaneou onset, leading to progressive dilatation, effacement of the cervix and delivery of the baby. The purpose of induction is to achieve benefit to the health of the mother and/or baby, greater than if the pregnancy continued. In recent years, the major fetal and maternal indications for IOL have not altered greatly. They still include prolonged pregnancy, pre-eclampsia, dysmaturity, antepartum haemorrhage, gross fetal abnormality, rhesus incompatibility, diabetes mellitus and fetal death in utero. In the UK the commonest indication is prolonged pregnancy. In addition, IOL is often performed now for cumulative indications, any of which if considered in isolation would probably constitute an insufficient reason: for example, increasing maternal age, previous infertility, poor obstetric history. Whatever the indication for induction it is essential that gestational age is calculated accurately. The rate of induction varies widely in different unit , and between individual obstetricians within the same unit.
Hydrops fetalis with isolated massive ascites in a preterm neonate with rhesus disease
