induction of labour

Question 1

what is induction of labour

Answer 1

when labour is initiated by the use of medications

may also include the use of amniotomy

Question 2

why might labour be induced

Answer 2

hypertensive disorders in pregnancy and other maternal medical conditions
maternal diabetes
prolonged pregnancy
twin pregnancy
prelabour rupture of membranes
foetal growth restriction/macrosmia
maternal request in exceptional circumstances
previous stillbirth/in utero death
post-dated uncomplicated pregnancy

Question 3

CI for induction

Answer 3

malpresentation
placenta/vasa praevia
prolapsed umbilical cord
foetal distress
anatomical abnormalities e.g. pelvic tumour

Question 4

relative CI to inductions

Answer 4

in real-life they are frequently performed in these circumstances
prev C section
maternal asthma

Question 5

what does a low Bishop score indicate

Answer 5

labour unlikely to start without induction

Question 6

medications used in induction of labour

Answer 6

topical prostaglandin analogues e.g. misoprostol - encourage cervical dilation and effacement
IV synthetic oxytocin (syntocinon) - initiates uterine contractions

Question 7

what is an alternative to topical prostaglandin analogues

Answer 7

balloon catheter is favourable

Question 8

what is required when inducing labour with medications

Answer 8

CTG monitoring

Question 9

mechanical methods of inducing labour

Answer 9

balloon catheter - favoured over medications

less likely to cause fetal distress (medications can cause hypertonicity)

Question 10

complications of induction of labour

Answer 10

uterine hypertonicity
foetal distress
adverse effects of drugs - hypotension, hyponatraemia
failed induction
C section 
ruptured uterus