Induction Of Labor Flashcards
What are the seven things that should be done in an induction
Put in orders Get an HPI Do a physical exam Get an ultrasound Consent for NSVD or csection SVE/SSE Plan
The four things you want in an ultrasound
Fetal weight
AFI
Fetal position
Placental location
What is the bishop score
Less than six cervix is unfavorable
If score is >8, probability of NSVD after labor induction is similar to that after spontaneous labor
Bishop score of zero
Cervix is closed it is posterior effacement is 0 to 30 station is -3 and it is firm
Bishop score of one
Dilation is 1 to 2 Cervix in mid position it is 40 to 50% effaced station is -2 Medium in consistency
Bishop score of two
Dilation is 3 to 4 cervix is anterior effacement is 60 to 70% station is -1 or zero and cervix is soft
Bishop score of three
Dilation is 5 to 6
effacement is 80%
station is +1 or +2
Name two agents for cervical ripening
Mechanical dilators and prostaglandins
Name to mechanical dilators
Foley bulb 30 to 80 cc
Cooks catheter 60 to 80 cc
What is the dose of miso pros too
Dose= 25 - 50 mcg q 3-6 hrs (in the absence of tachysystole)
Pt to remain recumbent for at least 30 mins s/p placement.
What is the protocol for oxytocin
Start with one and increase by two every 30 minutes
Max is 20
If you stop for less than 60 minutes restart
How does membrane stripping work
Significant increases in phospholipase A2 & prostaglandin F2a (PGF2a)
When can amniotomy be used
When cervix is favorable
What are some issues with cytotec
Tachysystole Uterine rupture Category three tracing Resuscitation +/- Terbutaline Increase risk of rupture in patients with prior C-section
What are some issues with oxytocin
Tachysystole uterine rupture and water intoxication at high doses
