Induction of labour Flashcards
indications
prolonged pregnancy, e.g. 1-2 weeks after the estimated date of delivery
prelabour premature rupture of the membranes, where labour does not start
diabetic mother > 38 weeks
pre-eclampsia
rhesus incompatibility
what is the bishops score?
used to help assess the whether induction of labour will be required.
what components does the bishop score measure?
Cervical position
Cervical consistency
Cervical effacement
Cervical dilation
Fetal station
what does the scoring for bishops score indicate?
a score of < 5 indicates that labour is unlikely to start without induction
a score of ≥ 8 indicates that the cervix is ripe, or ‘favourable’ - there is a high chance of spontaneous labour, or response to interventions made to induce labour
methods
membrane sweep
vaginal prostaglandin
maternal oxytocin infusion
amniotomy
cervical ripening balloon
complications
uterine hyperstimulation
what is uterine hyper stimulation
the main complication of induction of labour
refers to prolonged and frequent uterine contractions - sometimes called tachysystole
what are the potential consequences of uterine hyper stimulation?
intermittent interruption of blood flow to the intervillous space over time may result in fetal hypoxemia and acidemia
uterine rupture (rare)
Mx of uterine hyper stimulation
removing the vaginal prostaglandins if possible and stopping the oxytocin infusion if one has been started
tocolysis with terbutaline