induction of labour Flashcards
what is induction of labour
when labour is initiated by the use of medications
may also include the use of amniotomy
why might labour be induced
hypertensive disorders in pregnancy and other maternal medical conditions maternal diabetes prolonged pregnancy twin pregnancy prelabour rupture of membranes foetal growth restriction/macrosmia maternal request in exceptional circumstances previous stillbirth/in utero death post-dated uncomplicated pregnancy
CI for induction
malpresentation placenta/vasa praevia prolapsed umbilical cord foetal distress anatomical abnormalities e.g. pelvic tumour
relative CI to inductions
in real-life they are frequently performed in these circumstances
prev C section
maternal asthma
what does a low Bishop score indicate
labour unlikely to start without induction
medications used in induction of labour
topical prostaglandin analogues e.g. misoprostol - encourage cervical dilation and effacement
IV synthetic oxytocin (syntocinon) - initiates uterine contractions
what is an alternative to topical prostaglandin analogues
balloon catheter is favourable
what is required when inducing labour with medications
CTG monitoring
mechanical methods of inducing labour
balloon catheter - favoured over medications
less likely to cause fetal distress (medications can cause hypertonicity)
complications of induction of labour
uterine hypertonicity foetal distress adverse effects of drugs - hypotension, hyponatraemia failed induction C section ruptured uterus
