Induction of labour Flashcards
When is IOL offered when past due date
41-42 weeks gestation
When is IOL offered when due date isnt there yet
Prelabour rupture of membranes
Foetal growth restrivtuion
Pre-eclampsia
Obstetric cholestasis
Existing diabetes
IU foetal death
What score is used for induction?
Bishops score
What is used in the bishops score
Foetal station 0-3
Cervical position 0-2
Cervical dilatation 0-3
Cervical effacement 0-3
Cervical consistency 0-2
What bishops score predicts successful induction of labour
> 8
Membrane sweep how and when done
Separate amnion from uterine lining/stimulate cervix
Used from 40 weeks
Successful - starts in 48 hours
Options for induction of labour
Membrane sweep
Vaginal PGE2 inhibitors (gel, tablet, pessary)
Cervical ripening balloon (dilates)
AROM with oxytocin infusion
Oral mifepristone (antiprogesterone) + misoprostol
When use cervical ripening balloon
Prev C section
Vaginal prostaglandins failed
Multiparous > 3
When is mifepristone and misoprostol used to induce labour
when IU foetal death
Options when slow or no progress within 24 hours induction
Further vaginal prostaglandins
Artificial rupture of membranes and oxytocin infusion
Cervical ripening balloon (CRB)
Elective caesarean section
What is the main complication of induction
Uterine hyperstimulation - Prolonged contraction of uterus -> foetal distress and compromise
Criteria for uterine hyperstimulation n
Individual uterine contractions lasting more than 2 mins
More then 5 contractions every 10 mins
What can uterine hyperstimulation lead to
Foetal compromise, hypoxia and acidosis
Emergency C section
Uterine rupture
Management of uterine hyperstimulation
Removing vaginal prostaglandins or stopping oxytocin infusion
Tocolysis with terbutaline
