Induction of labour

Question 1

When should IOL first be discussed with mothers?

Answer 1

38 weeks

Question 2

When should IOL be offered in uncomplicated pregnancies?

What should be offered if declining IOL?

Answer 2

41-42 weeks

From 42 weeks- twice weekly CTG and USS for AFI

Question 3

PROM at term-

What should women be offered?

Answer 3

Expectant mx vs IOL at 24 hours

Question 4

What should VBAC be informed about IOL?

Answer 4

Increased risk LSCS

Increased risk uterine rupture (1% scar rupture synto)

Question 5

Can breech be offered IOL?

Answer 5

Not reccommended

Question 6

Contraindications to IOL?

Answer 6

Severe FGR with confirmed fetal compromise

Question 7

When should membrane sweeping be offered?

Answer 7

p0- 40+41 weeks

multip 41 weeks

Question 8

Compared with expectant mx, IOL at 41 weeks associated with fewer what?

Answer 8

Perinatal deaths
Mec aspiration
Caesarean section

Admission to NICU- no statistical difference

Question 9

PPROM

After 34 weeks- when should women be induced?

Answer 9

After 34 weeks there is no conclusive evidence about IOL vs expectant management, clinical picture should be considered and women should be offered options with advice

Question 10

Prostagladin vs balloon induction?

Why are mechanical methods not recommended by NICE

Answer 10

Balloon catheters do not reduced LSCS rates

They are associated with prolonged IOL and increased use of syntocinon