T2 - Induction and Augmentation (Josh) Flashcards
Guidelines for Induction of Labor are set by —
ACOG
***no elective induction until 39 wks
What are some indications for Induction of Labor?
Hypertensive complications of pregnancy
Fetal death
Chorioamnionitis
Diabetes Mellitus
Post term pregnancy, especially with oligohydramnios
IUGR – Intrauterine growth restriction
PROM with established fetal maturity
Isoimmunization
What are contraindications for Induction of Labor?
Acute, fetal distress
Shoulder presentation (transverse lie)
Face presentation
Floating fetal presenting part
Uncontrolled hemorrhage
Placenta Previa
Previous uterine incision that prohibits a trial of labor
What does Oxytocin do?
aids in labor
milk let down
What is the synthetic form of oxytocin?
pitocin
***double-check dosing b/c too much can rupture uterus
If contractions come too close together, what should we have available?
IV Fluids
Terbutaline (contraindicated in some hospitals b/c it causes tachycardia)
What do the Mechanical Methods of Induction attempt to do?
ripen the cervix by stimulating the release of endogenous prostaglandins
What are some Chemical Methods of Induction?
IV Pitocin
Amniotomy (AROM)
Prostaglandins (cervidel, cytotec, prepidil)
Herbals (black cohosh, raspberry leaves, primrose oil)
Examples of Mechanical Methods of Induction.
Dilators (absorb fluid and expand to cause cervical dilation)
Breast Stimulation
- releases oxytocin
Sexual Intercourse
Stripping Membranes
Castor Oil
What is Augmentation?
stimulation of UC after labor has started but progression is unsatisfactory
***same methods as Induction
What is the Definition of Labor?
Cervical Change
What can be used to evaluate iducability of a patient?
rating system like BISHOP SCORE (need score of 8 or more)
Is Oxytocin (Pitocin) a high alert med?
yes
it can rupture uterus if given in too high a dose
Oxytocin (Pitocin) dosage
Begin at 1 mu/min
Increase by 1-2 mu/min every 30-60 mins based on response of patient
