induction of labour and assisted delivery

Question 1

when nwould we need to induce labour ?

Answer 1

uncomplicated pregnancies 
pre-labour rupture of membranes 
maternal request 
intrauterine fetal death 
fetal growth restriction

Question 2

what are the different methods for the induction of labour ?

Answer 2

membrane sweeping 
pharmacological methods 
surgical methods 
non-pharmacological methods 
mechanical methods

Question 3

what is membrane sweeping ?

Answer 3

the insertion of two fingers into the cervix to detach the inferior pole of the membranes form the LUS in an attempt to initiate labour

Question 4

what are the pharmacological methods of inducing labour ?

Answer 4

prostaglandins:
vaginal PG E2 is the preferred method
misoprostol
oxytocin ( but not alone)

Question 5

what are the surgical methods for the induction of labour?

Answer 5

amniotomy

Question 6

what are the non pharmacological methods for the induction of labour ?

Answer 6

enema

castor oil

Question 7

what are the mechanical methods for the induction of labour ?

Answer 7

Laminara tent , which is a dehydrated seaweed that absorbs water from the surrounding tissue , expands and allows for the gradual dilatation of the cervix

Question 8

what are the complications of induction of labour ?

Answer 8

uterine hyperstimulation
failed induction
cord prolapse
uterine rupture

Question 9

what can be done in cases uterine hyperstimulation ?

Answer 9

tocolytics can be used

Question 10

when is assisted delivery needed ?

Answer 10

in inadequate progress in the second stage of labour
contraindication to maternal valsalva
suspected fetal compromise

Question 11

what tools are used for assisted delivery ?

Answer 11

ventouse

forceps

Question 12

what are the conditions to the use of a ventouse ?

Answer 12

need maternal effort
need good contractions
delivery happens over 3 contractions

Question 13

what are the conditions for the use of forceps ?

Answer 13

dont always need good contractions
dont need maternal effort
delivery happens over 3 contractions
usually quicker than a ventouse

Question 14

how can assisted vaginal birth be avoided ?

Answer 14

by continuous support during labour
not using epidural analgesia
delayed pushing
upright and lying down position

Question 15

what are the downsides to using the forceps versus the ventouse ?

Answer 15

forceps - has a higher chance of causing perineal tears

ventouse - failure to complete the birth is higher here

Question 16

when should you discontinue ventouse assisted birth ?

Answer 16

when there has been two “pop-offs” of the instrument

Question 17

when should you discontinue forceps assisted births ?

Answer 17

if birth is not imminent following three pulls of a correctly applied instrument

Question 18

what are the contraindications to assisted delivery ?

Answer 18

cervix not fully dilated 
head is more than 1/5 palpable in the abdomen
face presentation 
fetal bleeding disorder 
potential to fracture 
blood borne viral infections