Induction of Labour

Question 1

what are the indications for an induction of labour?

Answer 1

• prolonged pregnancy
• prelabour premature rupture of membranes
• maternal medical problems
• intrauterine fetal death

Question 2

what maternal medical problems are an indication for induction of labour?

Answer 2

• diabetic mother >38 weeks
• pre-eclampsia
• obstetric cholestasis

Question 3

what scoring system is used to assess whether induction of labour is required?

Answer 3

Bishop score

Question 4

what components are included in the bishop score?

Answer 4

• cervical position
• cervical consistency
• cervical effacement
• cervical dilation
• fetal station

Question 5

bishop score <5

Answer 5

labour is unlikely to start without induction

Question 6

bishop score >/= 8

Answer 6

high chance of spontaneous labour or response to interventions made to induce labour

Question 7

what is a membrane sweep?

Answer 7

examining finger passing through the cervix to rotate against the wall of the uterus to separate the chorionic membrane from the decidua

Question 8

name a vaginal prostaglandin E2

Answer 8

dinoprostone

Question 9

name an oral prostaglandin E1

Answer 9

misoprostol

Question 10

what is amniotomy?

Answer 10

‘breaking of water’s

Question 11

what is a cervical ripening balloon?

Answer 11

passed through the endocervical canal ad gently inflated to dilate the cervix

Question 12

bishop score </= 6

Answer 12

vaginal prostagladins or oral misoprostol

Question 13

bishop >6

Answer 13

amniotomy and IV oxytocin infusion

Question 14

what is the main complication of induction of labour?

Answer 14

uterine hyperstimulation

Question 15

what is the managemet of uterine hyperstimulation?

Answer 15

1. removing vaginal prostaglandins and stopping oxytocin infusion
2. consider tocolysis

Question 16

what is uterine hyperstimulation?

Answer 16

prolonged and frequent uterine contractions