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13 Cards in this Set
- Front
- Back
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Prerequisites for induvtion |
Capability for a C/S to be performed Ripe-able cervix Normal FHR Cephalic Likelihood of success (bishop score) |
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Induction vs Augmentation |
Artificial initiation vs promoting contractions when they aren't adequate |
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When do you induce someone? |
When the risk of continuing he pregnancy outweigh the risks of induction |
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How do you ripen a cervix |
Cervidil (prostaglandin vaginal insert) continuous slow release Prepidil PG gel: given once every 6-12 hrs upto 3 doses Or Foley Catheter |
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Bishop score |
Back (Definition) |
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Indications for induction |
Post dates >41 weeks most common reason Maternal diabetes second most common reason Gestational HTN Other maternal problems Isoimmumization, PROM, chorioamnioninS OR SUSPECTED FETAL JEOPARDY |
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Risks of induction |
Failure to achieve labour Uterine hyper stimulation and fetal compromise Maternal SE Uterine atony and PPH Uterine rupture |
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When do you ripen a cervix |
Bishop score <6 prior to inducing labour |
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Amniotony |
Artificial breaking the waters when the cervix is dilated to produce more PG. Much more effective when used in conjunction with oxytocin (RCT evidence) |
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Oxytocin for labour induction |
10U in 1L saline run at 0.5-2mU/min IV increasing by 1-2mU/min q20-60mins to a max of 36-48mU/min |
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Intravaginal PGE2 compared to the PG gel |
The cervidil has theoretical advantages 1. Insert without speculum 2. Slow continuous release 3. One dose only 4. Ability to use oxytocin 30 mins later 5. Ability to remove if required |
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Augmentation of labour |
Oxytocin regimen as for induction but differs in that it promotes adequate contractions that are already there |
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What is the half life of oxytocin |
3.5 mins |
