Induction & Augmentation Flashcards
Reasons to induce?
Preeclampsia Diabetes - depends on control Post maturity Twins FDIU Social Poor past obstetric history Compromise
Risk after membranes ruptured?
Chorioamnionitis
Placenta abrupt ion presents?
Bleeding
Reasons for significant abnormality termination?
Renal a genesis
Severe heart disease
Anencephaly
Reasons against induction?
Prematurity fetal growth restriction Fetal compromise Breech Placenta Pravin Previous Caesarian section Transverse lie Pelvis disproportion eg. Pelvic fractures PMHx
Methods to induce?
Prostin E2
ARM
Syntocinon
When should not use Prostin E2?
- Previous uterine scar
- ruptured membranes
Vaginal after C-section?
Trial by scar
DON’T INDUCE
ARM?
Amniotomy
Artificial Rupture of membranes
When do amniotomy? When not too.
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
Dosage of Syntocinon?
1-32 milli-units/ml
Side effects of Syntocinon?
Nausea, vomiting water intoxication and hyponatraemia
Complications of induction?
Cord prolapse
Uterine hyperstimulation - rupture
Fetal distress
May fail to induce labour - may need to C-section. (Not rare)
Kielland’s forceps for?
Help rotation, not used anymore.
Baby is engaged means?
Head is at the level of the ischial spines
4 kinds of instrumental delivery
(High)-don’t really do it, do a C-section
Mid
Low (easier)
Outlet (easiest)
Why do instrumental delivery?
2nd stage long Exhaustion Effective epidural Malposition of presenting part Fetal distress
Frankenhauser plexus?
Pelvic floor nerve bundle, primal need to push and expulsive effort
Instrumental delivery needs?
Cephalic presentation Fully dilated cervix Analgesia Epidural or spinal Catheter passed - empty bladder May need episiotomy
Forceps delivery may need?
Episiotomy
Ventouse suction need episiotomy?
Not necessarily
When do Nevile Barnes forceps used?
From anterior position
Ventouse complications?
Circular bruise
Subaponeurotic bleeding, intra cerebral bleeding
Forceps complications?
Bruising
Facial nerve palsy
Intracerebral bleed
C-sp damage
