post dates

Question 1

membrane sweeping

Answer 1

associated with a reduction in need for formal induction particularly with multiparous women
increases rate of spontaneous labour, although it may increase the incidence of uncomplicated bleeding and pain for women

Question 2

management principles of post dates

Answer 2

first trimester EDD should be used in preference to LMP
have a discussion at 40 weeks including maternal and fetal risks, management options, IOL
start fetal surveillence at 41 weeks

Question 3

antenatal risk factors to be aware of

Answer 3

increased blood pressure
history of nntepartum haemorrhage
more than one ttendnce with reduced fetal movements
intrauterine growth restriction
significant medical conditions
PROM
AMA

Question 4

how should you assess fetal wellbeing from 41 weeks

Answer 4

twice weekly CTG monitoring
twice weekly US examinations to measure amniotic fluid index (AFI)
the CTG and USS must be reviewed by registrar or above

Question 5

can you do membrane sweeping on GBS positive women

Answer 5

yes, studies show no increase in adverse outcomes

Question 6

procedure for stretch and sweep

Answer 6

ask woman to empty their bladder and encourage breathing techniques
perform abdo palpation and FHR assessment first
if the cervix is open, insert one finger through the internal os of the cervix to seperate the amniotic sac from the uterine wall and cervix by making circular sweeping movements as tolerated by the woman
auscultate FHR again after the procedure