Induction of Labour Flashcards
Between which weeks of gestation is induction of labour offered?
Induction of labour is offered between 41 and 42 weeks gestation.
List some indications for induction of labour.
Prelabour rupture of membranes
Fetal growth restriction
Pre-eclampsia
Obstetric cholestasis
Existing diabetes
Intrauterine fetal death
What is the Bishop score used for in relation to induction of labour?
The Bishop score is a scoring system used to determine whether to induce labour by assessing cervical readiness for labour.
The Bishop score is calculated by assessing the following 5 factors:
Fetal station (0-3)
Cervical position (0-2)
Cervical dilatation (0-3)
Cervical effacement (0-3)
Cervical consistency (0-2)
The minimum score is 0, and the maximum is 13.
What Bishop score indicates a successful induction of labour?
A score of 8 or more predicts a successful induction of labour.
What is a membrane sweep and when is it used?
A membrane sweep involves inserting a finger into the cervix to stimulate it and begin the process of labour. It is typically performed from 40 weeks gestation in women overdue to initiate labour before full induction.
What is the purpose of vaginal prostaglandin E2 (dinoprostone) in labour induction?
Vaginal prostaglandin E2 (dinoprostone) is used to stimulate the cervix and uterus to cause the onset of labour. It can be administered via gel, tablet (Prostin), or pessary (Propess) in a hospital setting
What is a cervical ripening balloon (CRB) and when is it used?
The cervical ripening balloon (CRB) is a silicone balloon inserted into the cervix and inflated to gently dilate it. It is used when vaginal prostaglandins are not preferred, especially in women with a previous caesarean section or multiparous women.
What is the role of artificial rupture of membranes (ARM) in induction of labour?
Artificial rupture of membranes is used to progress labour, often after the use of vaginal prostaglandins. It is typically combined with an oxytocin infusion.
What medication combination is used to induce labour in cases of intrauterine fetal death?
Oral mifepristone (anti-progesterone) plus misoprostol are used to induce labour in cases of intrauterine fetal death.
What is uterine hyperstimulation and how can it be caused?
Uterine hyperstimulation is a complication of induction of labour, primarily with vaginal prostaglandins, where uterine contractions are prolonged and frequent, leading to fetal distress.
What are the criteria for uterine hyperstimulation?
Individual uterine contractions lasting more than 2 minutes
More than five uterine contractions every 10 minutes
What are potential consequences of uterine hyperstimulation?
Fetal compromise, including hypoxia and acidosis
Emergency caesarean section
Uterine rupture
