T2-Induction and Augmentation Flashcards
The chemical or mechanical initiation of UC before their spontaneous onset for the purpose of bringing about birth
Induction of labor
What is the most important predictor of successful induction?
Cervical ripeness
What Bishop score usually means the induction of labor will be successful?
8 or higher
The stimulation of UC after labor has started spontaneously and progress is unsatisfactory
Augmentation
What do prostaglandins do?
Used to “ripen” (thin and soften) the cervix
T/F: After giving a prostaglandin sometimes women will spontaneously begin laboring, thereby eliminating the need to administer oxytocin to induce labor
True
What are some examples of physical methods used for induction/augmentation?
- Sex (prostaglands in semen)
- Nipple stimulation (release of endogenous oxytocin from pit. gland)
- Walking (gravity applies pressure to cervix and that stimulates secretion of endogenous oxytocin)
Artificial ROM
Amniotomy
T/F: Amniotomy is often used in combo with oxytocin induction
True
Stimulates UC and aids in milk let down
Oxytocin
Stimulation of ineffective UC after labor has started spontaneously but is not progressing satisfactorily
Augmentation of labor
Rating system to evaluate inability of the cervix; a higher score increases the rate of successful induction of labor
Bishop score
Birth of the fetus by an incision through the abdominal wall and uterus
C-section
Birth in which forceps are used to assist in delivery of the fetal head
Forcep assisted delivery
Birth iqvolinv attachment of a vacuum cup to fetal head and using negative pressure to assist in birth of fetus
Vacuum assist delivery
Period of observation to determine if a laboring woman is likely to be successful in progressing to a vaginal birth
Trial of labor
No elective induction until the woman reaches _____
39 weeks
What are indications for induction? (8)
- Chorioamnionitis
- Diabetes mellitus
- Fetal death
- HTN complications of preg
- Isoimmunization
- IUGR
- PROM with established fetal maturity
- Post term preg, especially with oligodyrdaminos
What are contraindications for induction? (7)
- Acute, fetal distress
- Face presentation
- Floating fetal presenting part
- Placenta previa
- Previous uterine incision that prohibits trial of labor
- Shoulder presentation
- Uncontrolled hemorrhage
What are the 5 relative contraindications for induction?
- Grand multiparty that ended after 20 weeks gestation
- Multiple gestation
- Suspected CPD
- Breech presentation
- Inability to adequately monitor FHR or UC (or both) throughout labor
What is synthetic form of oxytocin?
Pitocin
What are examples of prostaglandins?
- Cervidel
- Cytotec
- Prepidil
What prostaglandin is not approved by the FDA as a cervical ripening agent?
Cervidel
What are some herbal supplements used as chemical methods?
- Black cohosh
- Raspberry leaves
- Primrose oil
What do we need to have ready if contractions become too close together?
IV fluids and terbutaline
Why has terbutaline been contraindicated in some hospitals?
Its effects on the heart–it can cause tachycardia
What mechanical dilator is made of seaweed? What is the effect on the pt.?
Laminaria tents–> makes them very nauseated
What do mechanical dilators do?
Ripen the cervix by stimulating the release of endogenous prostaglandins
What does ingestion of castor oil do?
Stripping the membranes
What is the difference in augmentation and induction?
Augmentation labor has already started its just moving slowly….induction is initiation of the UC before they have started
