Induction of labour

Question 1

IOL for LGA

Answer 1

OASIS - higher with IOL
SD - lower with IOL (no difference if no diabetes)
Perinatal death - no difference
HIE - no difference
Mat satisfaction - no difference
Brachial plexus injury - no difference
CS - no difference

Question 2

Cochrane review on PG/Foleys/Miso

Question 3

NICE guidelines for IOL

Question 4

When may a baby be injured at CS

Answer 4

Impacted
Macrosomic
Malpresentation

Question 5

How can an impacted CS be managed

Answer 5

Senior do VE
Consider measures - fetal pillow, GTN, trendelenberg, breech extraction

Question 6

Maternal morbidity with impacted head?

Answer 6

Urinary tract injury
Angle extensions
PPH

Question 7

Rate of a subgaleal

Answer 7

1 in 2500 for VND
1 in 250 for kiwi/ventous

Higher risk if nullip, >20min cup application, >3 pulls,

Question 8

Differential diagnosis of subgaleal

Answer 8

Cephalohaematoma - does not cross suture lines
Caput succedaneum
Chignon