Class 6: Induction & Augmentation Labor Flashcards
what is induction of labor
- chemical or mechanical initiation of uterine contractions before their spontaneous onset for the purpose of bringing about the birth
what is augmentation of labor
- the stimulation of uterine contractions after labor has started spontaneously but progress has been unsatisfactory
what is elective induction of labor
- when the pregnant person wants to be induced
- not typically allowed
what are risks of elective induction (3)
- increased incidence of c-section
- neonatal morbidity
- and costs
what are indications for labor induction (14)
- pre-eclampsia >37 weeks
- signif antepartem hemorrhage (placental abruption, NOT previa)
- chorioamniotitis
- suspected fetal compromise (ex. poor BPP score, poor doptone analysis)
- term prelabor rupture of membranes with maternal GBS colonization
- postdates
- uncomplicated twin pregnancy >38 weeks pregnancy
- diabetes
- alloimmune disease
- IUGR
- oligohydramnios
- gestational HTN > 38 weeks gestation
- intrauterine fetal death
- PROM near or at term (GBS negative)
if membranes rupture, will give pregnant person 24 h to go into labor unless… (2)
- GBS positive
- signs of infection
what is a contraindication for induction
- placenta previa
- other factors that contradict general labor
what is used to help us determine when to start an induction?
- bishop score
what does the bishop score determine?
- when the cervix is favorable for induction –> identify cervical ripening (softening)
what can be given to promote cervical ripening
- chemical agents (prostaglandins)
- mechanical and physical methods (balloon catheter)
what are 2 prostaglandin gels that are inserted into the posterior part of the vagina
- prostin
- prepadol
what is a postaglandin topical agent attached to a string that can be pulled out of the vagina if strong labor is accidentally induced
- cervadil
prostaglandins can cause..
- induction, but rare
what is required monitoring after admin of a cervical ripening agent
- continuous fetal monitoring for 1 hr
describe use of a balloon catheter for cervical ripening
- balloon inserted into the uterus
- pokes the amniotic membranes which are closely laid against cervix
= triggers release of prostaglandins - keep inflated balloon in cervix for 24 h or will fall out on its own as cervix dilates
