Induction Flashcards
1
Q
Definition of Induction
A
The process of attempting to initiate labour by stimulating uterine contractions and ripening of the cervix
2
Q
Contraindications of Induction
A
- Severe IUGR
- Labour has started
- Fetal compromise
- Prev uterine surgery
- Grand multiparity (=>6)
- Oxytocic drugs are in use
- Unexplained bleeding
3
Q
Propess Pessary
A
- Preferred first line for parous <3
- A pessary containing Dinoprostine which causes the cervix to soften and open, causing contraction
4
Q
Propess Procedure
A
- CTG
- = reassuring VE,
- =<7 Insert propess to posterior fornix
- Semi-recumbent for 30 mins
- CTG
- @12 hours either telephone and ask progress or do check
- Remove if any changes or if >7
- @24 hours remove propess and do check
- If @ 3cm then amniotomy, if not consultant review
5
Q
Prostin E2 gel
A
- Preferred first line in parous 4+5, or second line in parous <3
6
Q
Prostin E2 gel Procedure
A
- CTG
- = reassuring VE
- = If prim <4 then 2mg, if parous or >4 then 1mg
- Insert to posterior fornix
- Semi-recumbent for 30 mins
- CTG
- @ 6 hours VE
- If change + contraction = wait for labour, if change but no contraction = 1 mg, if no changes = 2mg.
- @ 6 hours VE
- If change = amniotomy, if not consultant review.
7
Q
Amniotomy
A
Refers to the artifical rupturing of membraines if at 3cm using an amnihook.
8
Q
Amniotomy Procedure
A
- CTG
- Complete amniotomy
- Record colour and amount of liquor
- FHR
- Encourage mobililsation
- In prims with no UA - commence Oxytocin
- In parous then assess ua after 2 hours , if ua less than 3:10, commence oxytocin
9
Q
Oxytocin Infusion
A
A hormone given to initiate contractions and help increase the release of prostaglandins.
10
Q
Oxytocin Infusion Procedure
A
30IU of oxytocin in 500ml sodium chloride 0.9% solution. 1ml/1hr = 1milliunit/min. Increase at intervals of 30 minutes. - 2ml/hr - 4ml/hr - 8ml/hr - 12ml/hr - 16ml/hr - 20ml/hr (CONSULTANT) -24ml/hr - 28ml/hr - 32ml/hr
