1F - Induction and Augmentation of Labor

Question 1

What defines successful induction of labor?

Answer 1

Vaginal delivery within 24 to 48 hours

Question 2

What do we call the induction of labor in the absence of acceptable fetal or maternal indications?

Answer 2

Elective induction

Question 3

What is >5 contractions per 10 mins period averaged over 30 mins?

Answer 3

tachysystole

Question 4

A verbal consent is enough to validate labor induction? T or F

Answer 4

False

Question 5

What fetal lie is contraindicated for labor induction?

Answer 5

Footling breech and transverse lie

Question 6

What bishop score is considered to be favorable for induction?

Answer 6

8

Question 7

What bishop score indicates an unfavorable cervix?

Answer 7

6

Question 8

What is the normal length of the cervix of a woman?

Answer 8

25mm

Question 9

A 50% effaced cervix is shaped as?

Answer 9

Funnel

Question 10

What is the normal shape of the endocervical canal?

Answer 10

Tube shaped

Question 11

What anatomical structure is the basis for the station of the fetus?

Answer 11

Ischial spine

Question 12

The position of the cervix is relative to what fetal and maternal structure?

Answer 12

Fetal head and maternal pelvis

Question 13

A soft cervix is likened to what structure of the body?

Answer 13

Lips

Question 14

A hard cervix is likened to what structure of the body?

Answer 14

Nose

Question 15

When can induction of labor be advised if the patient has controlled DM with oral hypoglycemis?

Answer 15

39 weeks

Question 16

If the mother has DM being controlled with insulin, how many weeks of gestation can induction of labor be advised?

Answer 16

38 weeks

Question 17

How many weeks of gestation can a fetus with intrauterine growth restriction be advised for induction of labor?

Answer 17

36 weeks or term if possible to prevent stillbirth

Question 18

What is the complication if a dead fetus is retained for more than 4 weeks?

Answer 18

DIC

Question 19

If a mother experiences premature rupture of membranes at less than 34 weeks with no other complications, can induction of labor be advised?

Answer 19

No

Monitor patient, give steroids and check for chorioamnionitis

Question 20

After premature rupture of membranes at more than 34 weeks(matured lungs) what risks are discussed before induction of labor?

Answer 20

sepsis and NICU availability

Question 21

If the premature rupture of membranes occur before 32 weeks of gestation, what can we give to protect the fetus?

Answer 21

magnesium sulfate for neuroprotection and steroids for lung maturation

Question 22

Tocolysis is recommended for PPROM before 34 weeks? T or F?

Answer 22

False

Question 23

Induction of labor in uncomplicated twin pregnancy is recommended at what AOG?

Answer 23

37 weeks

Question 24

What form of twin pregnancy will induction of labor be contraindicated?

Answer 24

Monoamniotic with 1st twin not in cephalic presentation

Question 25

It is recommended to wait to 42 weeks of pregnancy before advising induction of labor? T or F?

Answer 25

False At 41 completed weeks, induction of labor can be advised *39 weeks with no complications is when we can consider induction of labor

Question 26

What plant medicine is used in the Philippines as a uterotonic?

Answer 26

Sambong

Question 27

What mechanism do the mechanical devices for induction of labor use?

Answer 27

Stimulation for the release of prostaglandins and local pressure

Question 28

What endogenous substance is responsible for the ripening of the cervix by relaxation of smooth muscles for dilatation and increase in myometrial contractions?

Answer 28

Prostaglandin

Question 29

What presentation is viable for induction of labor?

Answer 29

Cephalic presentation

Question 30

When do we do CTG monitoring for induction of labor?

Answer 30

Before and after induction of labor

Question 31

What is grand multiparity which is a contraindication to induction of labor?

Answer 31

5 or more previous births

Question 32

What dose of dinoprostone (PGE2) is initially used for multiparous women?

Answer 32

1 mg

Question 33

What dose of dinoprostone (PGE2) is initially used for nulliparous women with unfavorable cervix?

Answer 33

2 mg

Question 34

What is the maximum dose per 12 hours of dinoprostone for nulliparous women with unfavorable cervix?

Answer 34

4 mg 3 mg for all other women

Question 35

this is a synthetic PGE1 analog for cervical ripening

Answer 35

Misoprostol.

Question 36

The mechanism for cervical dilatation and cervical ripening by stripping of membrane is by?

Answer 36

increase in phospholipase activity and prostaglandin

Question 37

How is strpping of the membrane done?

Answer 37

Inserting two fingers as far from the internal os as possible and rotating twice to separate membranes from the lower segment

Question 38

What is the first polypeptide synthesized to induce or augment labor?

Answer 38

Oxytocin

Question 39

How many hours after rupture of membranes is the golden period where risk for chorioamnionitis is minimal?

Answer 39

24 hrs

Question 40

Artificial rupture of membranes requires commitment to vaginal delivery? T or F?

Answer 40

True *72 hours

Question 41

Amniotomy in unengaged position poses risk for?

Answer 41

Cord prolapse

Question 42

Sudden decompression of the uterus due to leakage by amniotomy can lead to?

Answer 42

Placental abruption

Question 43

The fingers which control flow of amniotic fluid outward by amniotomy should only be removed after what event?

Answer 43

When the presenting part rests against the cervix

Question 44

Amniotomy alone is recommended for induction of labor? T or f?

Answer 44

False

Question 45

What is administered immediately or after two hours post amniotomy?

Answer 45

Oxytocin

Question 46

Amniotomy can be used for augmentation?

Answer 46

Yes - when spontaneous labor is abnormally slow

Question 47

What is the next step after a failed induction?

Answer 47

Either CS or repeat induction

Question 48

For patients with pre eclampsia, what AOG can we advise induction?

Answer 48

34 weeks