RNSG 1412 (Ob/Pedi) - Exam 2, PPT & Learning Guide: Complications
of L&D / OB Procedures|Obstetric Procedures, Amniotomy, Artificial Rupture
of Membranes, Induction, Labor Augmentation, Cervical Ripening, Bishop Score,
Oxytocin Administration, Pitocin Titration, Mechanical Methods, Medical
Methods, Prostaglandins, Misoprostol, Dinoprostone, Fetal Monitoring, Uterine
Contractions, Operative Vaginal Birth, Episiotomy, Cesarean Birth, Maternal-
Fetal Assessment, Contraindications, Complications, Risk Management, Nursing
Considerations, Preoperative Care, Postoperative Care, Pain Management,
Patient Education, Infection Prevention, Hemodynamic Monitoring, Labor
Progress Evaluation, Elective Induction, Nonreassuring FHR Patterns, Evidence-
Based Obstetric Care Exam Questions Verified and Provided with Complete A+
Graded Rationales Latest Updated 2026
OB procedures
•1. Amniotomy
•2. Induction/augmentation
•3. Version
•4. Operative vaginal birth
•5. Episiotomy
•6. Cesarean birth
OB Procedures 1. Amniotomy
•Amniotomy is the artificial rupture of the amniotic sac with a tool called amniohook (a long crochet
type hook, with a pricked end)
•The amniotic sac is broken/ruptured by RN or provider.
AROM: Artificial Rupture of Membranes
(SROM: Spontaneous Rupture of Membranes)
,Amniotomy Indications & Risks
Indications:
•Induction/augmentation
•Prompted by the need for internal EFM
Risks:
§Prolapse (high station?)
§Infection
§Abruptio Placenta (placental abruption)
Amniotomy Nursing Considerations
Prior:
FHR baseline
During:
Supplies/Assist
Observation
After:
Assessments:
•FHR (what are you assessing for?)baseline & watching for decels. we want a Cat 1 strip before
•Charting (what?) amount, color, clarity, odor, who perfprmed it.
,•Temperature (frequency? What to report?) Q2, temp > 100.4
•Comfort (another reason to change moist pads?)
-frequently change chucks to prevent infection
Prioritize the assessments.
Is there a difference between SROM and AROM assessments?
No
OB procedures: 2. Induction & Augmentation of Labor
Indication: It is more beneficial to deliver than to stay pregnant.
What are indications for the artificial initiation (induction) of labor? mom or baby are having issues and
it's more beneficial to deliver than stay pregnant.
What is an elective induction? mom chooses to schedule it.
pt. have to be at least 39 weeks.
What is the difference between induction and augmentation?
induction = mom not in labor at all
, augmentation = mom in labor but needs help progressing
Indications for induction (pg. 380- know these for exam)
Fetal compromise (e.g., intrauterine growth restriction, maternal-fetal blood incompatibility,
oligohydramnios)
• Spontaneous rupture of the membranes at or near term without onset of labor (premature rupture of
the membranes [PROM])
• Postterm pregnancy
• Chorioamnionitis (inflammation of the amniotic sac)
• Hypertension associated with pregnancy or chronic hypertension, both of which are associated with
reduced placental blood flow
• Abruptio placentae (large abruptions require immediate delivery) (see Chapter 27)
• Maternal medical conditions that are worsening with continuation of the pregnancy (e.g., diabetes,
renal disease, pulmonary disease, and chronic hypertension)
• Fetal death
Induction & Augmentation of Labor
FIRST: Provider evaluates!
Success of induction depends on the cervix.
The Bishop’s score predicts probable success of induction… (What if induction is not successful?)
Parameters of the Bishop’s score:
•dilation
of L&D / OB Procedures|Obstetric Procedures, Amniotomy, Artificial Rupture
of Membranes, Induction, Labor Augmentation, Cervical Ripening, Bishop Score,
Oxytocin Administration, Pitocin Titration, Mechanical Methods, Medical
Methods, Prostaglandins, Misoprostol, Dinoprostone, Fetal Monitoring, Uterine
Contractions, Operative Vaginal Birth, Episiotomy, Cesarean Birth, Maternal-
Fetal Assessment, Contraindications, Complications, Risk Management, Nursing
Considerations, Preoperative Care, Postoperative Care, Pain Management,
Patient Education, Infection Prevention, Hemodynamic Monitoring, Labor
Progress Evaluation, Elective Induction, Nonreassuring FHR Patterns, Evidence-
Based Obstetric Care Exam Questions Verified and Provided with Complete A+
Graded Rationales Latest Updated 2026
OB procedures
•1. Amniotomy
•2. Induction/augmentation
•3. Version
•4. Operative vaginal birth
•5. Episiotomy
•6. Cesarean birth
OB Procedures 1. Amniotomy
•Amniotomy is the artificial rupture of the amniotic sac with a tool called amniohook (a long crochet
type hook, with a pricked end)
•The amniotic sac is broken/ruptured by RN or provider.
AROM: Artificial Rupture of Membranes
(SROM: Spontaneous Rupture of Membranes)
,Amniotomy Indications & Risks
Indications:
•Induction/augmentation
•Prompted by the need for internal EFM
Risks:
§Prolapse (high station?)
§Infection
§Abruptio Placenta (placental abruption)
Amniotomy Nursing Considerations
Prior:
FHR baseline
During:
Supplies/Assist
Observation
After:
Assessments:
•FHR (what are you assessing for?)baseline & watching for decels. we want a Cat 1 strip before
•Charting (what?) amount, color, clarity, odor, who perfprmed it.
,•Temperature (frequency? What to report?) Q2, temp > 100.4
•Comfort (another reason to change moist pads?)
-frequently change chucks to prevent infection
Prioritize the assessments.
Is there a difference between SROM and AROM assessments?
No
OB procedures: 2. Induction & Augmentation of Labor
Indication: It is more beneficial to deliver than to stay pregnant.
What are indications for the artificial initiation (induction) of labor? mom or baby are having issues and
it's more beneficial to deliver than stay pregnant.
What is an elective induction? mom chooses to schedule it.
pt. have to be at least 39 weeks.
What is the difference between induction and augmentation?
induction = mom not in labor at all
, augmentation = mom in labor but needs help progressing
Indications for induction (pg. 380- know these for exam)
Fetal compromise (e.g., intrauterine growth restriction, maternal-fetal blood incompatibility,
oligohydramnios)
• Spontaneous rupture of the membranes at or near term without onset of labor (premature rupture of
the membranes [PROM])
• Postterm pregnancy
• Chorioamnionitis (inflammation of the amniotic sac)
• Hypertension associated with pregnancy or chronic hypertension, both of which are associated with
reduced placental blood flow
• Abruptio placentae (large abruptions require immediate delivery) (see Chapter 27)
• Maternal medical conditions that are worsening with continuation of the pregnancy (e.g., diabetes,
renal disease, pulmonary disease, and chronic hypertension)
• Fetal death
Induction & Augmentation of Labor
FIRST: Provider evaluates!
Success of induction depends on the cervix.
The Bishop’s score predicts probable success of induction… (What if induction is not successful?)
Parameters of the Bishop’s score:
•dilation
