Labor induction is a medical process used to initiate uterine contractions and achieve vaginal birth before labor begins naturally. At 37 weeks of gestation, a pregnancy is considered “early term.” This distinction is important when considering induction, as it influences decisions regarding maternal and fetal well-being.
Understanding 37 Weeks Gestation
While many consider 37 weeks full-term, it is medically classified as “early term.” A full-term pregnancy occurs between 39 weeks and 40 weeks and 6 days. This distinction is important because fetal development continues in the final weeks, with a baby’s lungs, brain, and liver still maturing.
Delivering a baby before 39 weeks can impact these processes. Lung maturity is a primary consideration, as babies born before 39 weeks may have a higher chance of breathing difficulties. Waiting until at least 39 weeks allows for further maturation, contributing to better health outcomes for the newborn. Unless medical reasons suggest otherwise, allowing the pregnancy to continue naturally toward full term is preferred.
Medical Necessity for Induction
Labor induction at 37 weeks is reserved for situations where continuing the pregnancy poses a greater risk to the mother or baby than early delivery. Healthcare providers carefully weigh these considerations. A common reason for induction is preeclampsia, a serious condition characterized by high blood pressure. Gestational hypertension, high blood pressure without other preeclampsia symptoms, can also necessitate early induction.
Gestational diabetes, especially if poorly controlled, is another circumstance for induction at 37 weeks. Intrahepatic cholestasis of pregnancy (ICP), a liver condition causing bile to build up in the bloodstream, often leads to induction around 37 or 38 weeks due to risks like stillbirth. Fetal growth restrictions, where the baby is not growing as expected, or premature rupture of membranes (PROM) without labor onset can also be reasons for induction.
Potential Outcomes of Early Induction
Inducing labor at 37 weeks can lead to various outcomes for both the mother and the baby. For the mother, induction may increase the likelihood of interventions, including a longer labor process or a cesarean section. A failed induction, where the procedure does not result in a vaginal birth, can also lead to a C-section.
For the baby, potential outcomes include a higher chance of admission to the neonatal intensive care unit (NICU). Transient tachypnea of the newborn (TTN), a temporary breathing disorder caused by fluid remaining in the baby’s lungs, is a specific respiratory concern. This condition is more common in babies delivered by C-section and those born before 38 completed weeks. Although TTN usually resolves within 48 to 72 hours, other issues like feeding difficulties or temperature regulation challenges may arise in early-term infants.
The Process of Labor Induction
The process of labor induction involves several methods to prepare the cervix and stimulate uterine contractions. One common approach is cervical ripening, which aims to soften, thin, and open the cervix. This can be achieved using prostaglandins, which are hormone-like substances administered orally, vaginally as a pill, gel, or suppository. Prostaglandins help prepare the cervix and can also initiate contractions.
Mechanical methods are also used for cervical ripening, such as the insertion of a balloon catheter into the cervix. This device, often a Foley catheter, has a balloon inflated with saline to apply pressure, encouraging dilation. Once the cervix is ripe or partially dilated, labor stimulation methods are employed. Synthetic oxytocin, administered intravenously, is a medication that mimics the body’s natural hormone to cause or strengthen uterine contractions. Another method, amniotomy, involves artificially rupturing the amniotic sac using a small hook-like instrument, which can help induce or speed up labor by releasing hormones and allowing the baby’s head to put pressure on the cervix.