Induction & Augmentation

Question 1

Reasons to induce?

Answer 1

Preeclampsia
Diabetes - depends on control
Post maturity
Twins
FDIU
Social
Poor past obstetric history
Compromise

Question 2

Risk after membranes ruptured?

Answer 2

Chorioamnionitis

Question 3

Placenta abrupt ion presents?

Answer 3

Bleeding

Question 4

Reasons for significant abnormality termination?

Answer 4

Renal a genesis
Severe heart disease
Anencephaly

Question 5

Reasons against induction?

Answer 5

Prematurity
fetal growth restriction
Fetal compromise
Breech
Placenta Pravin
Previous Caesarian section
Transverse lie
Pelvis disproportion eg. Pelvic fractures PMHx

Question 6

Methods to induce?

Answer 6

Prostin E2
ARM
Syntocinon

Question 7

When should not use Prostin E2?

Answer 7

• Previous uterine scar

- ruptured membranes

Question 8

Vaginal after C-section?

Answer 8

Trial by scar

DON’T INDUCE

Question 9

ARM?

Answer 9

Amniotomy

Artificial Rupture of membranes

Question 10

When do amniotomy? When not too.

Answer 10

Only when head is close to cervix.

If it’s too far, all fluid will rush out and maybe take the cord with it. Cord prolapse

Question 11

Dosage of Syntocinon?

Answer 11

1-32 milli-units/ml

Question 12

Side effects of Syntocinon?

Answer 12

Nausea, vomiting water intoxication and hyponatraemia

Question 13

Complications of induction?

Answer 13

Cord prolapse
Uterine hyperstimulation - rupture
Fetal distress
May fail to induce labour - may need to C-section. (Not rare)

Question 14

Kielland’s forceps for?

Answer 14

Help rotation, not used anymore.

Question 15

Baby is engaged means?

Answer 15

Head is at the level of the ischial spines

Question 16

4 kinds of instrumental delivery

Answer 16

(High)-don’t really do it, do a C-section
Mid
Low (easier)
Outlet (easiest)

Question 17

Why do instrumental delivery?

Answer 17

2nd stage long
Exhaustion
Effective epidural
Malposition of presenting part
Fetal distress

Question 18

Frankenhauser plexus?

Answer 18

Pelvic floor nerve bundle, primal need to push and expulsive effort

Question 19

Instrumental delivery needs?

Answer 19

Cephalic presentation
Fully dilated cervix
Analgesia Epidural or spinal
Catheter passed - empty bladder
May need episiotomy

Question 20

Forceps delivery may need?

Answer 20

Episiotomy

Question 21

Ventouse suction need episiotomy?

Answer 21

Not necessarily

Question 22

When do Nevile Barnes forceps used?

Answer 22

From anterior position

Question 23

Ventouse complications?

Answer 23

Circular bruise

Subaponeurotic bleeding, intra cerebral bleeding

Question 24

Forceps complications?

Answer 24

Bruising
Facial nerve palsy
Intracerebral bleed
C-sp damage