T2 - Induction and Augmentation (Josh) Flashcards Preview

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Flashcards in T2 - Induction and Augmentation (Josh) Deck (14):
1

Guidelines for Induction of Labor are set by ---

ACOG

***no elective induction until 39 wks

2

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

3

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

4

What does Oxytocin do?

aids in labor

milk let down

5

What is the synthetic form of oxytocin?

pitocin

***double-check dosing b/c too much can rupture uterus

6

If contractions come too close together, what should we have available?

IV Fluids

Terbutaline (contraindicated in some hospitals b/c it causes tachycardia)

7

What do the Mechanical Methods of Induction attempt to do?

ripen the cervix by stimulating the release of endogenous prostaglandins

8

What are some Chemical Methods of Induction?

IV Pitocin

Amniotomy (AROM)

Prostaglandins (cervidel, cytotec, prepidil)

Herbals (black cohosh, raspberry leaves, primrose oil)

9

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

10

What is Augmentation?

stimulation of UC after labor has started but progression is unsatisfactory

***same methods as Induction

11

What is the Definition of Labor?

Cervical Change

12

What can be used to evaluate iducability of a patient?

rating system like BISHOP SCORE (need score of 8 or more)

13

Is Oxytocin (Pitocin) a high alert med?

yes

it can rupture uterus if given in too high a dose

14

Oxytocin (Pitocin) dosage

Begin at 1 mu/min

Increase by 1-2 mu/min every 30-60 mins based on response of patient