IOL & Augmentation; Flashcards
What is induction of Labour?
An artificial method of initiating labour, by prostaglandins
What is augmentation?
A process where the progress of labour is enhanced by administration of oxytocin
What is the incidence of induction with reference?
Amount of labours that were induced in 2016-2017 were 29.4% which was an increase from 20.3% (NHS Digital, 2017)
What are the fetal factors of inducing?
IUGR
IUD
Fetal anomaly not compatible with life
What are the Maternal factors of inducing?
Prolonged pregnancy
Hypertension
Diabetes
PROM
What are the other factors of inducing?
Obstetric HX
Previous IUD
Infertility
what are the different ways used in order to encourage the cervix to ripen.
Prostaglandin via Gel
Prostaglandin via Pessary
One cycle of vaginal prostaglandin via tablets or gel, give another dose in 6hours if labour is not yet established .
If using pessary, one dose over 24hrs can be used
What does ARM stand for and what is it?
Artificial rupture of membranes, which is another form of augmentation of labour or IOL, usually done if bishop score is more than or equal to 7.
how is oxytocin used to enhanced labour ?
It is used to stimulate uterine contractions at the rate of 4:10, lasting 40-30secs
What are the side effects of prostaglandins being used.
Propess which is the pessary is the first line of prostagladin for nullips, but it can be easily removed; ineffective.
both prostin and propess can cause the uterus to contract too much or be be stimulated too much which may lead to fetal distress, FHR changes or uterine rupture
can cause nausea, vomiting and diarrhoea
if administered too many times some mothers complain of irritation
Name 4 side effects of oxytocin being used.
causes hyperstimulation which can lead to the symptoms of prostaglandins, and placental abruption
Should’t not be given within the 6 hrs that the prostaglandins were given
can also cause gastric disturbances , headache and tachycardia- ensure that they are not just as a consequence of labour.
What is the role of the midwife in IOL and augentation?
Take care of women’s preferences and choices; respecting their decisions
midwife must tailor the care for the individual and should support them holistically
Midwife should facilitate maternal choice of pain relief and additional options if needed
monitor the progress of labour carefully
safe medicines management
rapid action if hyper stimulation occurs
Name one alternatve therapy that is considered to work for augmentation and ref?
Acupuncture to has been known to induce pregnancy, however, research suggests that there is an insufficient amount of evidence for this to be a stable intervention. (Smith et al 2013).
