Induction of labor

Question 1

What are the indications for induction of labor?

Answer 1

BENEFITS > RISKS

1. prolonged pregnancy (post date)
2. Baby
   - foetal growth restriction
3. Placenta/membranes
   - PROM
   - chorioamnionitis (inflammation of fetal membranes)
   - unexplained antepartum haemorrhage
4. Mother
   - PIH/Preeclampsia
   - Diabetes
   - Renal disease
   - other pathology causing risk.
5. Logistics - distance from hospital.

Question 2

Contraindications

Answer 2

Baby
- transverse fetal lie

Placenta/membranes

• placenta previae
• vasa previae

Mother

• herpes infection
• pelvic abnormalities
• previous uterine incision

Question 3

What is the bishop score?

Answer 3

>8 = successful
<8 = unlikely to be successful --> proceed to LSCS

1. Cervical Dilation
2. Cervical Effacement
3. Cervical Consistency
4. Cervical Position
5. Fetal station.

Question 4

What are the 3 main processes by which labor can be induced, and what methods of induction are used in each?

Answer 4

1. Cervical ripening - softening and effacement of the uterus.

A. Membrane sweep “stretch and sweep”

• gloved finger is inserted through the cervix and is rotated against the wall of the uterus.
• Strips the chorionic villi from the underlying decidua.

B. Foley urethral balloon