Induction of Labour Flashcards
What is induction of labour?
Artificially starting labour.
What are the main indications for inducing labour?
Fetal:
- Prolonged pregnancy >42 weeks
- Pre labour term spontaneous rupture of membranes
- IUGR
Maternal:
- Gestational diabetes
- Pre-eclampsia
- Chronic renal/pulmonary disease
What are the contraindications to induction of labour?
Maternal:
- Cannot cope with labour due to serious chronic illness
- Active genital herpes
Fetal:
- Malpresentation
- Fetal distress
Placental:
- Cord prolapse
- Placenta previa
- Previous classical c-section (longitudinal scar)
What is the bishop’s score what does it assess?
Cervical status:
Dilation Effacement Station Consistency Cervical position
Don’t Ever State Conservatives Care
A score of 5 or less suggests that labour is unlikely to start without induction. A score of 9 or more indicates that labour will most likely commence spontaneously
What are the different methods of inducing labour?
Membrane sweeping. (separation of the membranes from the cervix leads to the release of endogenous prostaglandins)
Prostaglandin gel or pessary.
Oral prostaglandin (misoprostol)
Oxytocin with/or without artificial rupture of membranes.
What do you need to do when using prostaglandins to induce labour?
CTG 30mins before induction
CTG after medication
VE after 6 hours
Do not start oxytocin if PG’s were used for 6 hours.
What do you need to do when using syntocin to induce labour?
Start on the lowest possible dose (1-4mU/min)
Double every 30 mins until optimal contractions have been reached (3-4 in 10mins) or max dose 40mU/min.
Continuous CTG monitoring
Check U/e’s if used for more than 12hrs as has a similar effect as ADH therefore can cause dilutional hyponatraemia.
What are the complications of inducing labour?
Higher rates of C-section
Higher rates of medical interventions
Hyper stimulation
PPH
