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OBSTETRICS > 1F - Induction and Augmentation of Labor > Flashcards

1F - Induction and Augmentation of Labor Flashcards

1
Q

What defines successful induction of labor?

A

Vaginal delivery within 24 to 48 hours

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2
Q

What do we call the induction of labor in the absence of acceptable fetal or maternal indications?

A

Elective induction

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3
Q

What is >5 contractions per 10 mins period averaged over 30 mins?

A

tachysystole

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4
Q

A verbal consent is enough to validate labor induction? T or F

A

False

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5
Q

What fetal lie is contraindicated for labor induction?

A

Footling breech and transverse lie

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6
Q

What bishop score is considered to be favorable for induction?

A

8

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7
Q

What bishop score indicates an unfavorable cervix?

A

6

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8
Q

What is the normal length of the cervix of a woman?

A

25mm

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9
Q

A 50% effaced cervix is shaped as?

A

Funnel

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10
Q

What is the normal shape of the endocervical canal?

A

Tube shaped

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11
Q

What anatomical structure is the basis for the station of the fetus?

A

Ischial spine

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12
Q

The position of the cervix is relative to what fetal and maternal structure?

A

Fetal head and maternal pelvis

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13
Q

A soft cervix is likened to what structure of the body?

A

Lips

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14
Q

A hard cervix is likened to what structure of the body?

A

Nose

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15
Q

When can induction of labor be advised if the patient has controlled DM with oral hypoglycemis?

A

39 weeks

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16
Q

If the mother has DM being controlled with insulin, how many weeks of gestation can induction of labor be advised?

A

38 weeks

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17
Q

How many weeks of gestation can a fetus with intrauterine growth restriction be advised for induction of labor?

A

36 weeks or term if possible to prevent stillbirth

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18
Q

What is the complication if a dead fetus is retained for more than 4 weeks?

A

DIC

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19
Q

If a mother experiences premature rupture of membranes at less than 34 weeks with no other complications, can induction of labor be advised?

A

No

Monitor patient, give steroids and check for chorioamnionitis

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20
Q

After premature rupture of membranes at more than 34 weeks(matured lungs) what risks are discussed before induction of labor?

A

sepsis and NICU availability

21
Q

If the premature rupture of membranes occur before 32 weeks of gestation, what can we give to protect the fetus?

A

magnesium sulfate for neuroprotection and steroids for lung maturation

22
Q

Tocolysis is recommended for PPROM before 34 weeks? T or F?

A

False

23
Q

Induction of labor in uncomplicated twin pregnancy is recommended at what AOG?

A

37 weeks

24
Q

What form of twin pregnancy will induction of labor be contraindicated?

A

Monoamniotic with 1st twin not in cephalic presentation

25
Q

It is recommended to wait to 42 weeks of pregnancy before advising induction of labor? T or F?

A

False

At 41 completed weeks, induction of labor can be advised

*39 weeks with no complications is when we can consider induction of labor

26
Q

What plant medicine is used in the Philippines as a uterotonic?

A

Sambong

27
Q

What mechanism do the mechanical devices for induction of labor use?

A

Stimulation for the release of prostaglandins and local pressure

28
Q

What endogenous substance is responsible for the ripening of the cervix by relaxation of smooth muscles for dilatation and increase in myometrial contractions?

A

Prostaglandin

29
Q

What presentation is viable for induction of labor?

A

Cephalic presentation

30
Q

When do we do CTG monitoring for induction of labor?

A

Before and after induction of labor

31
Q

What is grand multiparity which is a contraindication to induction of labor?

A

5 or more previous births

32
Q

What dose of dinoprostone (PGE2) is initially used for multiparous women?

A

1 mg

33
Q

What dose of dinoprostone (PGE2) is initially used for nulliparous women with unfavorable cervix?

A

2 mg

34
Q

What is the maximum dose per 12 hours of dinoprostone for nulliparous women with unfavorable cervix?

A

4 mg

3 mg for all other women

35
Q

this is a synthetic PGE1 analog for cervical ripening

A

Misoprostol.

36
Q

The mechanism for cervical dilatation and cervical ripening by stripping of membrane is by?

A

increase in phospholipase activity and prostaglandin

37
Q

How is strpping of the membrane done?

A

Inserting two fingers as far from the internal os as possible and rotating twice to separate membranes from the lower segment

38
Q

What is the first polypeptide synthesized to induce or augment labor?

A

Oxytocin

39
Q

How many hours after rupture of membranes is the golden period where risk for chorioamnionitis is minimal?

A

24 hrs

40
Q

Artificial rupture of membranes requires commitment to vaginal delivery? T or F?

A

True

*72 hours

41
Q

Amniotomy in unengaged position poses risk for?

A

Cord prolapse

42
Q

Sudden decompression of the uterus due to leakage by amniotomy can lead to?

A

Placental abruption

43
Q

The fingers which control flow of amniotic fluid outward by amniotomy should only be removed after what event?

A

When the presenting part rests against the cervix

44
Q

Amniotomy alone is recommended for induction of labor? T or f?

A

False

45
Q

What is administered immediately or after two hours post amniotomy?

A

Oxytocin

46
Q

Amniotomy can be used for augmentation?

A

Yes - when spontaneous labor is abnormally slow

47
Q

What is the next step after a failed induction?

A

Either CS or repeat induction

48
Q

For patients with pre eclampsia, what AOG can we advise induction?

A

34 weeks

OBSTETRICS (36 decks)

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