NMH

NMH | 2024 271 Appendices Appendix 2: Classification of indications for caesarean section in spontaneous labour or after having had labour induced Fetal reason Caesarean section for fetal indication before any oxytocin has been given. Dystocia Inefficient uterine action/inability to treat/fetal intolerance Problem is inadequate progress with no fetal problems until oxytocin is started. Inefficient uterine action/inability to treat/ overcontracting Problem is inadequate progress but oxytocin does not reach maximum dose as per protocol in unit because of overcontracting uterus. Inefficient uterine action/poor response Problem is inadequate progress which does not improve after being treated with the maximum dose of oxytocin according to the protocol in the unit. Inefficient uterine action/no oxytocin Problem is inadequate progress which for whatever reason has not been treated with oxytocin. Efficient uterine action/CPD/POP* Adequate progress (1cm/hr) and in nulliparous women would need to have been treated with oxytocin) but vaginal delivery not possible. *In multiparous women the term CPD/POP is replaced with obstructed labour. CLASSIFICATION OF INDICATIONS FOR INDUCTIONS OF LABOUR Fetal reasons Includes all indications for induction that are carried out for the benefit of the fetus. PET/Hypertension Includes all indications for induction that are carried out for hypertensive disorders. Post Dates Includes all inductions that are carried out specifically for 42 weeks gestation or greater. SROM Includes all inductions for spontaneous rupture of the membranes Maternal reasons/Pains Includes all indications for induction that are carried out for the benefit of the mother including pains not in labour Non medical reasons/Dates< 42 weeks Includes all indications for inductions where there is no absolute medical indication or for dates but less than 42 weeks

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