Induction of Labour Flashcards
What is augmentation of labour?
This is an attempt to increase the progress of labour, and applies to a spontaneous labour that has slowed down or ceased, or when membranes rupture without contractions
What are the main methods of augmentation of labour?
- Artificial rupture of membranes
- IV Oxytocin
What is induction of labour?
This is an intervention designed to artificially inotiate uterine contractions leading to progressive dilatation and effacement of the cervix and birth of the baby
What are the main methods of induction of labour?
- Membrane sweep
- Prostaglandin (2mg) E2 pessary
- Artificial rupture of membranes (using amnihook)
- Balloon catheter
- IV Syntocinon
What are the fetal indications for induction of labour?
- IUGR
- Fetal distress
- Post dates (usually induce around 41 weeks)
- IUD
- Isoimmunisation
- Previous stillbirth
- Recurrent reduced fetal movements
What are the contraindications for IoL?
- Transverse/oblique lie
- Active genital herpes
- HIV depending on viral load
- Placenta/vasa previa
- Umbilical cord prolapse
What are the contraindications for IoL?
- Transverse/oblique lie
- Active genital herpes (to avoid vertical transmission)
- HIV depending on viral load
- Placenta/vasa previa
- Umbilical cord prolapse
How can cervical favourability be monitored?
Bishop score
How does a membrane sweep work?
It increases the activity of phospholipase and prostaglandin
What is the ideal rate of contractions?
4-5 every 10 minutes
What are the complications of IoL?
- Increased risk of C-section (cascade of intervention)
- Cord prolapse
- Intrauterine infection (chorioamnitis)
- Fetal compromise
- Uterine hyperstimulation
- Uterine rupture
- PPH
What are the maternal indications for IoL?
- Maternal request
- Gestational Diabetes
- SPD
- Hypertensive disorders
- Obstetric cholestasis
- Recurrent APH
