Induction of labour

Question 1

What are indications for IOL

Answer 1

1. prolonged pregnancy
2. prelabour premature rupture of the membranes, where labour does not start
3. diabetic mother > 38 weeks
4. rhesus incompatibility

Question 2

What are contraindications of IOL

Answer 2

• malpresentations
• fetal distress
• placenta praevia
• cord presentation
• vasa praevia
• pelvic tumour

Question 3

What is the scoring system to predict whether IOL is required?

Answer 3

Bishops

Question 4

What does this scoring system take into account?

Answer 4

cervical dilation
length of cervix
station 
cervical consistency 
position of cervix

Question 5

What does a higher score on this scoring system indicate?

Answer 5

that labour will most likely commence spontaneously

Question 6

What does a lower score on this scoring system indicate?

Answer 6

that labour is unlikely to start w/o induction

Question 7

What is the first method of inducing labour

Answer 7

membrane sweeping - passing a finger through the cervix and stripping between the membranes and lower segment of the uterus (chorionic membrane from decidua)

Question 8

What is the second method of inducing labour

Answer 8

intravaginal prostaglandins

prostaglandin E2 gel is inserted into the posterior vaginal fornix

Question 9

what is the third method of inducing labour

Answer 9

breaking waters - artificial ROM

Question 10

What is the fourth method if within 2 hrs labour hasn’t ensued?

Answer 10

oxytocin

Question 11

when is misoprostol offered?

Answer 11

when there has been fetal death