Prostaglandins

Induction succeeds when uterine force meets a cervix that can respond. A firm, posterior, closed cervix can produce painful contractions without meaningful dilation, so cervical ripening may be the safer first step than simply escalating oxytocin. Prostaglandins alter cervical tissue and may activate the myometrium at the same time. That dual effect explains both their usefulness and their main hazard: the same dose that softens the cervix can create contractions that are too frequent for placental recovery. The nurse therefore links three findings after every dose: the Bishop score, the contraction pattern, and the fetal heart-rate tracing. A client who develops five or more contractions in 10 minutes is no longer in routine ripening; the response must shift from promoting labour to stopping excessive uterine stimulation and protecting fetal oxygenation.