W8 - Induction and Augmentation of Labour Flashcards
(11 cards)
what are the indications for an induction of labour
over 41 weeks
rupture of membranes
maternal health
- gestational diabetes
- age >40
- HTN and preeclampsia
large for gestational age
concerns for baby
- reduced movements
what are some complications of induction
- Epidural pain
- Prolonged labour
- Uterine hyperstimulation
- Cord prolapse
- Uterine rupture
- Shoulder dystocia
- Postpartum haemorrhage
- Unsuccessful induction
what needs to be assessed before IOL
stability of baby head in pelvis
USS - position of baby
foetal HR using CTG
confirm absence of contractions
what are the physical methods of induction
membrane sweep
balloon catheter
DILAPAN
Artificial rupture of membranes
what are the methods for medical induction
Dinoprostone - gel and propess
misoprostone - tablet
oxytocin - IV
what are the 3Ps causes of delayed labour
Power
Passage
Passenger
what causes of delayed labour are due to power
- Previous pelvic fractures
- Cervical stenosis
- Vaginal septum
- Female genital Mutilation
- Pelvic masses
- Full Bladder
- Full Rectum
- Abnormal placental position
- Bandl’s ring
- Fibroids
- Contractions
- not frequent enough 4:10
- not long enough
- no powerful enough
what causes of delayed labour are due to passage
- Malposition
- OP/OT
- Asynclitism
- Deflexion
- Breech – 1/3 of labours
- Transverse
- Shoulder
- Brow/Face
what causes of delayed labour are due to passenger
- Foetus:
- Hydrocephalus
- Hydrops
- Macrosomia
- Cystic hygroma
- Goitre
what are some complications of augmentation of labour
- Infection
- Uterine Hypersensitivity
- Atonic PPH
- Uterine rupture – 0.07%
- Instrumental deliveries
- C/S
- Perineal trauma
why would you use a balloon catheter rather than prostaglandins on some women
previous c section
