Acceleration and Augmentation of Labour

Initiation of labor by amniotomy and a shortening of the subsequent induction-delivery interval is termed accelerated labor. Augmented labor occurs when steps are taken to shorten a labor process which has already started but has continued for too long. A review of the literature is made to present a picture of the gradual progression toward the routine use of labor acceleration and augmentation in modern obstetric practice. Acceleration by rupture of the fetal membranes is more successful in primigravidae than in multigravidae especially women having a child after the 3rd. It is also more successful at low parity and after the 38th week of pregnancy. The various methods of administering pitocin or other oxytocic substances which have been used are summarized. Intravenous infusion carries advantages over the other administration routes which outweigh the disadvantages. Changes have taken place in the timing and dosage of oxytocin use after amniotomy in the years since 1964; these are traced through the literature. The advantages of accelerated labor are contrasted with the disadvantages and/or contraindications.