Induction Of Labour Flashcards
What are the parameters measured by the Bishops score?
Cervical: Dilation Effacement Consistency Station Position
What is the bishops score of a favorable cervix?
> 9
What are the three broad methods of induction of labour?
Medical, surgical and mechanical
What are the two widely used prostaglandins in the induction of labour?
Misoprostol (prostaglandin E1 analogue)
Dinoprostone- prandin gel E2
How is misoprostol administered?
200 mcg tablets dissolved in 20 ml
At term:
25 mcg as a test dose, 25 mcg half an hour later then 150 mcg in 3 divided doses
NO MISOPROSTOL IF UTERUS IS CONTRACTING
2nd trimester:
100 mcg every 4-6 hours
IUD at term:
50 mcg 4 hourly
What are the contraindications to misoprostol?
Previous c section and multifarious patients
How is prandin administered?
Vaginally into the posterior fornix every 6 hours ( max 2 doses)
When is prostaglandin F 2 alpha used?
Termination of pregnancy
Not used with viable pregnancies
What are the side- effects of oxytocin?
Tetanic contractions, hypertonic uterus (>5 contractions in 10 minutes), fetal distress, water intoxication
What are the precautions when doing an amniotomy?
- aseptic technique
- lithotomy position preferable
- exclude cord presentation
- supra pubic pressure if high head or polyhydramnios
- auscultation of fetal heart before and after the procedure
- assess colour of liquor (clear, meconium or blood- stained)
What are the mechanical methods of induction?
Stretch and sweep
Foleys catheter
What are indications for the induction of labour
Maternal: Pre- eclampsia/ eclampsia Prolonged rupture of membranes Chorioamnionitis Maternal medical conditions (diabetes) Previous unexplained stillbirth
Fetal
Intra-uterine death
Growth restriction
Prolonged pregnancy
