Induction of Labour

Question 1

What is the induction of labour?

Answer 1

Process where labour is started artificially

Question 2

How is induction done?

Answer 2

It can be done either with medication or devices to ripen the cervix

Question 3

What are some reasons for the induction of labour?

Answer 3

Prolonged pregnancy 
Diabetic mother 
Pre-eclampsia 
Rhesus incompatibility 
Oligohydramnios

Question 4

What is oligohydramnios?

Answer 4

Placental insufficiency

Question 5

What are some contraindications for the induction of pregnancy?

Answer 5

Malpresentation
Placenta praevia
Prolapsed umbilical cord
Fetal distress

Question 6

What is the main complication of the induction of pregnancy?

Answer 6

Uterine hyperstimulation

Question 7

What is uterine hyperstimulation?

Answer 7

Prolonged and frequent uterine contractions

Question 8

What is a potential consequence of uterine hyperstimulation?

Answer 8

Intermittent interruption of blood flow to the intervillous space

Question 9

What can the interruption of blood flow to the intervillous space cause?

Answer 9

Fetal hypoxaemia and acidaemia

Question 10

What is the management of uterine hyperstimulation?

Answer 10

Removal of vaginal prostaglandins and stop oxytocin infusion
Tocolysis and terbutaline

Question 11

What is the Bishop’s score used for?

Answer 11

To clinically assess the cervix

Question 12

What does a Bishop’s score of less than 5 indicate?

Answer 12

It indicates that labour is unlikely to start without induction

Question 13

What does a Bishop’s score of more than 8 suggest?

Answer 13

The cervix is ripe

High chance of spontaneous labour

Question 14

What does a high bishop’s score indicate?

Answer 14

There is more progressive change in the cervix

induction is more likely to be successful

Question 15

What is amniotomy?

Answer 15

The artificial rupture of the fetal membranes

Question 16

How is the artificial rupture of the membranes done?

Answer 16

Using a sharp device

Question 17

What is the ideal Bishop’s score for an amniotomy?

Answer 17

Bishop’s score of 7

Question 18

What would you give to the patient after an amniotomy if she isn’t contracting naturally?

Answer 18

IV oxytocin

Question 19

What are the medical methods for the induction of labour?

Answer 19

Topical Vaginal Prostaglandin E2 analogues

IV synthetic oxytocin (syntocinon)

Question 20

What is the function of the prostaglandin E2 analogues?

Answer 20

Encourage cervical dilatation and effacement

Question 21

What is the function of oxytocin?

Answer 21

Induces uterine contractions

Question 22

What is the preferred medical method of induction of labour?

Answer 22

Prostaglandin E2 analogues

Question 23

What is the mechanical method of inducing labour?

Answer 23

Balloon Catheter

Question 24

How does a balloon catheter induce labour?

Answer 24

It is passed through the endocervical canal

Then it is gently inflated to dilate cervix

Question 25

What is the preferred way of inducing labour?

Answer 25

The balloon catheter

Question 26

What is the balloon catheter preferred over prostaglandin E2 analogues?

Answer 26

It is less likely to cause fetal distress due to hypertoxicity