Induction of Labour

Question 1

What are indications for IOL?

Answer 1

Prolonged pregnancy
Prelabour premature rupture of membranes where labour does not start
Maternal medication problems such as GDM or PET
Foetal growth restriction
Foetal death

Question 2

What is the Bishop Score?

Answer 2

Used to assess whether IOL will be successful- assesses cervical readiness for labour induction

Score <5 indicates labour unlikely to start without induction
Score >8 indicates the cervix is ripe high chance of spontaneous labour or response to interventions made

Question 3

What are the steps of inducing labour?

Answer 3

Membrane sweep stimulates prostaglandin release which can initiate labour within 48 hours

Dinoprostone (prostaglandin E2) or oral misoprostol
- indicated in women with bishop score <6

Amniotomy follow by IV oxytocin
- if bishop score >6

Question 4

What are potential complications?

Answer 4

Uterine hyperstimulation
- prolonged and frequent uterine contractions
- can increase risk of foetal hypoxia
- management with removing prostaglandins and stopping oxytocin

Increased risk of instrumental or C section
Foetal distress