ACOG Practice Bulletin: Induction of Labor Questions
With Complete Solutions
How do you appropriately measure uterine contractions?
Correct Answers Count the number of contractions present in a
ten minute window averaged over 30 minutes.
Mostly Review: How long should latent labor go on before a
patient is diagnosed with failed induction? Correct Answers At
least 12-18 hours of latent labor should be allowed before
diagnosing a failed induction to reduce the risk of cesarean
delivery.
-This is assuming that there haven't been contractions of 200
Montevedo units that have failed to dilate the cervix. If THIS is
the case, then the cut off is 4 hours.
Mostly review: What are side effects of Laminaria japonicum
and hygroscopic dilators? Correct Answers Increased maternal
and neonatal infections
Mostly review: What are some clinical scenarios in which labor
induction may be indicated? Correct Answers -Placental
abruption
-Chorioamnionitis
-Fetal demise
-Gestational HTN
-Preeclampsia/eclampsia
-PROM
-Postterm pregnancy
-Maternal medical conditions (DM, renal disease, chronic
pulmonary disease, chronic HTN, antiphospholipid syndrome)
, -Fetal compromise (severe growth restriction, isoimmunization,
oligohydramnios
Mostly review: What are the contraindications for labor
induction? Correct Answers Basically, they are the same
contraindications as those for spontaneous labor and vaginal
delivery:
-Vasa previa/complete placenta previa
-Transverse fetal lie
-Umbilical cord prolapse
-*Previous classical cesarean delivery*
-Active genital herpes infection
-Previous myomectomy entering the endometrial cavity
Mostly review: What are the risks associated with amniotic
stripping? Correct Answers Risk of bleeding from
undiagnosed placenta previa or low-lying placenta, and
accidental amniotomy.
Mostly review: What are the risks of amniotomy when used to
induce labor? What should you do prior to the amniotomy to
make sure? Correct Answers -Prolapsed umbilical cord
-Chorioamnionitis
-Significant umbilical cord compression and rupture of vasa
previa.
-Physician should first palpate for an umbilical cord and avoid
dislodging the fetal head
Mostly Review: What are the side effects of using oxytocin for
labor induction? Correct Answers Dose-related tachysystole
and category II or III tracings are most common.
With Complete Solutions
How do you appropriately measure uterine contractions?
Correct Answers Count the number of contractions present in a
ten minute window averaged over 30 minutes.
Mostly Review: How long should latent labor go on before a
patient is diagnosed with failed induction? Correct Answers At
least 12-18 hours of latent labor should be allowed before
diagnosing a failed induction to reduce the risk of cesarean
delivery.
-This is assuming that there haven't been contractions of 200
Montevedo units that have failed to dilate the cervix. If THIS is
the case, then the cut off is 4 hours.
Mostly review: What are side effects of Laminaria japonicum
and hygroscopic dilators? Correct Answers Increased maternal
and neonatal infections
Mostly review: What are some clinical scenarios in which labor
induction may be indicated? Correct Answers -Placental
abruption
-Chorioamnionitis
-Fetal demise
-Gestational HTN
-Preeclampsia/eclampsia
-PROM
-Postterm pregnancy
-Maternal medical conditions (DM, renal disease, chronic
pulmonary disease, chronic HTN, antiphospholipid syndrome)
, -Fetal compromise (severe growth restriction, isoimmunization,
oligohydramnios
Mostly review: What are the contraindications for labor
induction? Correct Answers Basically, they are the same
contraindications as those for spontaneous labor and vaginal
delivery:
-Vasa previa/complete placenta previa
-Transverse fetal lie
-Umbilical cord prolapse
-*Previous classical cesarean delivery*
-Active genital herpes infection
-Previous myomectomy entering the endometrial cavity
Mostly review: What are the risks associated with amniotic
stripping? Correct Answers Risk of bleeding from
undiagnosed placenta previa or low-lying placenta, and
accidental amniotomy.
Mostly review: What are the risks of amniotomy when used to
induce labor? What should you do prior to the amniotomy to
make sure? Correct Answers -Prolapsed umbilical cord
-Chorioamnionitis
-Significant umbilical cord compression and rupture of vasa
previa.
-Physician should first palpate for an umbilical cord and avoid
dislodging the fetal head
Mostly Review: What are the side effects of using oxytocin for
labor induction? Correct Answers Dose-related tachysystole
and category II or III tracings are most common.
