Maternal child, Nursing care of women with complications during L and D, ch 8 PP
Bishop scoring system -Health care providers can use Bishop's score to determine a patient's potential
for successful induction.
"Cervical readiness" or "Favorable for induction"
Evaluates the cervical response to induction procedures
A high score (above 6) is predictive of successful labor induction because the
cervix has ripened or softened in preparation for labor
Indications for Labor Induction -Gestational hypertension
-Ruptured membranes without spontaneous onset of labor
-Infection within the uterus
-Maternal medical problems that worsen during pregnancy
Fetal problems:
-slowed growth, prolonged pregnancy, or incompatibility between fetal and
maternal blood types
-Placental insufficiency
-Fetal death
Contraindications for labor induction -Placenta previa
-Umbilical cord prolapse
-Abnormal fetal presentation
-High station of the fetus
-Active herpes infection in the birth canal
-Abnormal size or structure of the mother's pelvis
-Previous classic (vertical) cesarean incision
Pharmacological Methods to Stimulate Contractions Cervical ripening
-Prostaglandin in a gel or vaginal insert is applied before labor induction to soften
the cervix
-Laminaria is an alternative to cervical ripening by swelling inside the cervix
Oxytocin induction and the augmentation of labor
-Used to initiate or stimulate contractions
-Most commonly used method
, Maternal child, Nursing care of women with complications during L and D, ch 8 PP
Cervical ripening softening and effacing the cervix prior to induction when the Bishop score is 4 or
less.
Regardless if ripening or augmenting labor, fetal monitoring is done either
intermittent or continuous
Preparing the Woman for Labor Augmentation Explain procedure to woman
Obtain baseline vital signs and fetal heart rate
Ensure IV line is placed
Remains in bed for up to 2 hours
Oxytocin induction can start 6-12 hours after vaginal insert has been removed
Assess for signs of uterine tachysystole
Dilating the cervix -RU486 (Mifepristone): steroid receptor agonist use for early pregnancy
termination
-Stripping amniotic membranes
-Hydroscopic dilators
-Transcervical balloon dilators
-Extra-amniotic saline infusion
Obstetric Procedures Amniotomy
-The artificial rupture of membranes
-Done to stimulate or enhance contractions
-Commits the woman to delivery
-Stimulates prostaglandin secretion
Complications
-Prolapse of the umbilical cord
-Infection
-Abruptio placentae
Amniotomy: nursing Monitor FHR before, during & after
-Variables, decelerations, fetal distress
-Vaginal exam for prolapsed cord
Observe fluid
-Amount
-Color
Complications Associated with Amniotomy Prolapsed umbilical cord
Infection
Abruptio placentae
Bishop scoring system -Health care providers can use Bishop's score to determine a patient's potential
for successful induction.
"Cervical readiness" or "Favorable for induction"
Evaluates the cervical response to induction procedures
A high score (above 6) is predictive of successful labor induction because the
cervix has ripened or softened in preparation for labor
Indications for Labor Induction -Gestational hypertension
-Ruptured membranes without spontaneous onset of labor
-Infection within the uterus
-Maternal medical problems that worsen during pregnancy
Fetal problems:
-slowed growth, prolonged pregnancy, or incompatibility between fetal and
maternal blood types
-Placental insufficiency
-Fetal death
Contraindications for labor induction -Placenta previa
-Umbilical cord prolapse
-Abnormal fetal presentation
-High station of the fetus
-Active herpes infection in the birth canal
-Abnormal size or structure of the mother's pelvis
-Previous classic (vertical) cesarean incision
Pharmacological Methods to Stimulate Contractions Cervical ripening
-Prostaglandin in a gel or vaginal insert is applied before labor induction to soften
the cervix
-Laminaria is an alternative to cervical ripening by swelling inside the cervix
Oxytocin induction and the augmentation of labor
-Used to initiate or stimulate contractions
-Most commonly used method
, Maternal child, Nursing care of women with complications during L and D, ch 8 PP
Cervical ripening softening and effacing the cervix prior to induction when the Bishop score is 4 or
less.
Regardless if ripening or augmenting labor, fetal monitoring is done either
intermittent or continuous
Preparing the Woman for Labor Augmentation Explain procedure to woman
Obtain baseline vital signs and fetal heart rate
Ensure IV line is placed
Remains in bed for up to 2 hours
Oxytocin induction can start 6-12 hours after vaginal insert has been removed
Assess for signs of uterine tachysystole
Dilating the cervix -RU486 (Mifepristone): steroid receptor agonist use for early pregnancy
termination
-Stripping amniotic membranes
-Hydroscopic dilators
-Transcervical balloon dilators
-Extra-amniotic saline infusion
Obstetric Procedures Amniotomy
-The artificial rupture of membranes
-Done to stimulate or enhance contractions
-Commits the woman to delivery
-Stimulates prostaglandin secretion
Complications
-Prolapse of the umbilical cord
-Infection
-Abruptio placentae
Amniotomy: nursing Monitor FHR before, during & after
-Variables, decelerations, fetal distress
-Vaginal exam for prolapsed cord
Observe fluid
-Amount
-Color
Complications Associated with Amniotomy Prolapsed umbilical cord
Infection
Abruptio placentae
