If the amniotic sac membranes have ruptured and are verified using Nitrazine paper, fetal lung maturity is assessed. If the fetus is determined to be mature for delivery, labor is induced.
Most pregnancies are induced if the danger to the fetus or mother is significant if continued. Possible indications include hypertensive emergencies such as preeclampsia and eclampsia, as well as other maternal medical problems including gestational diabetes and chorioamnionitis. Traumatic events also may be an indication for an induction.
Gestations that are prolonged are often induced for delivery on an elective basis. Elective induction of labor increases the risk of future deliveries to be cesarean.
Abnormalities in placental development such as placenta previa and abruptio placenta are delivered via cesarean and never induced for delivery as the potential for hemorrhage is high.
Improper positioning of the infant into a transverse lie indicates that the shoulder would be the first presenting part during labor. Cesarean is indicated in all cases when found during delivery.
Prolapse of the umbilical cord after the rupture of membranes in an indication of cesarean delivery as compression of the umbilical cord during delivery would cause excess fetal stress and possibly death.
Genital herpes infections that are active are an indication for cesarean delivery as it can be passed to the infant during passage through the birth canal. Herpes virus is a TORCH infection and may cause a systemic viral infection leading to brain damage.
Previous incisions into the uterine muscle causes localized weakness and scarring after healing. Since scars are weaker areas of tissue, uterine contractions may cause rupture. Some types of incisions, like low transverse, allow patient to attempt to deliver vaginally. Due to the increased risk of intrapartum uterine rupture during labour following previous transfundal uterine incision, planned repeat cesarean birth is preferred in these instances.
Any hemorrhage or vaginal bleeding that has an unknown cause indicates cesarean delivery, as it could indicate placenta previa, abruptio placenta, or other vaginal trauma.
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