NM704 Mod4 Part B Labor Induction: Ultimate Guide
With Verified Solutions
The uterine response to
oxytocin depends on the duration of the pregnancy; there
is a gradual increase in response from _______________ weeks of
gestation, followed by a plateau from of ____________ gestation
until term, when sensitivity increases Right Ans - from 20 to 30
34 weeks
Compared with placebo or oxytocin alone, vaginal
prostaglandins used for cervical ripening increase the
likelihood __________________increase the risk of _____________ Right Ans - + of
delivery within 24 hours, do not reduce the
rate of cesarean delivery, and
+ uterine tachysystole with associated FHR changes
Cochrane Review on misoprostol for labor induction found that use of
__________________ resulted in fewer cesarean births than _____________ Right
Ans - .oral misoprostol
.vaginal dinoprostone, with no differences in negative outcomes for mother or
baby
Their most important physiologic function of prostaglandins Right Ans - is
the ability to cause contraction or relaxation of smooth muscle.
This includes smooth muscle other than that of the cervix or uterus, and can
have important implications regarding unintended side effects of
prostaglandins
Why can prostaglandins induce labor at any GA? Right Ans - prostaglandins
in all smooth muscle, including myometrium
Can oxy induce labor at any GA, like pg? Right Ans - No.
oxytocin is dependent on the development of receptors in myometrial tissue
just before and during labor to exert its uterotonic effects.
Misoprostol (Cytotec®): Right Ans - synthetic PGE1 analog used for pre-
induction cervical ripening, and first and second trimester abortions.
, Dinoprostone (Cervidil® or Prepidil®): Right Ans - PGE2 used for pre-
induction cervical ripening and first or second trimester abortion.
Carboprost (Hemabate®): Right Ans - PGF2 used for control of postpartum
hemorrhage and first or second trimester abortion.
why is it difficult to know how well prostaglandins do in preparing cervix for
labor? Right Ans - complicated by the fact that there are many variations in
terms of type of prostaglandin, form of administration, route of
administration, and dosage regimens
_______________________________are both effective cervical ripening agents Right
Ans - PGE1 and PGE2
primary adverse effect of possible uterine tachsystole with_____________
Right Ans - PGE1 and PGE2
Why is the use of misoprostol for cervical ripening controversial Right Ans
- + off label warning by manufacturer
+ risk of rupture
The risk of uterine rupture with misoprostol in a non-scarred uterus is
associated with dosages Right Ans - higher than are currently
recommended.
Part of the misoprostol off label use controversy stems from our inability to
Right Ans - answer the question of whether misoprostol used in low doses to
induce labor in women without prior cesareans, is any less safe than other
agents used for the same purpose.
in RCTs with miso and cervadil - Right Ans - serious complications were
rare and there was little difference between the two
FDA warning for miso states: Right Ans - warning was changed in May of
2002 to state that misoprostol is contraindicated for use as an antiulcer drug
in pregnant women.
With Verified Solutions
The uterine response to
oxytocin depends on the duration of the pregnancy; there
is a gradual increase in response from _______________ weeks of
gestation, followed by a plateau from of ____________ gestation
until term, when sensitivity increases Right Ans - from 20 to 30
34 weeks
Compared with placebo or oxytocin alone, vaginal
prostaglandins used for cervical ripening increase the
likelihood __________________increase the risk of _____________ Right Ans - + of
delivery within 24 hours, do not reduce the
rate of cesarean delivery, and
+ uterine tachysystole with associated FHR changes
Cochrane Review on misoprostol for labor induction found that use of
__________________ resulted in fewer cesarean births than _____________ Right
Ans - .oral misoprostol
.vaginal dinoprostone, with no differences in negative outcomes for mother or
baby
Their most important physiologic function of prostaglandins Right Ans - is
the ability to cause contraction or relaxation of smooth muscle.
This includes smooth muscle other than that of the cervix or uterus, and can
have important implications regarding unintended side effects of
prostaglandins
Why can prostaglandins induce labor at any GA? Right Ans - prostaglandins
in all smooth muscle, including myometrium
Can oxy induce labor at any GA, like pg? Right Ans - No.
oxytocin is dependent on the development of receptors in myometrial tissue
just before and during labor to exert its uterotonic effects.
Misoprostol (Cytotec®): Right Ans - synthetic PGE1 analog used for pre-
induction cervical ripening, and first and second trimester abortions.
, Dinoprostone (Cervidil® or Prepidil®): Right Ans - PGE2 used for pre-
induction cervical ripening and first or second trimester abortion.
Carboprost (Hemabate®): Right Ans - PGF2 used for control of postpartum
hemorrhage and first or second trimester abortion.
why is it difficult to know how well prostaglandins do in preparing cervix for
labor? Right Ans - complicated by the fact that there are many variations in
terms of type of prostaglandin, form of administration, route of
administration, and dosage regimens
_______________________________are both effective cervical ripening agents Right
Ans - PGE1 and PGE2
primary adverse effect of possible uterine tachsystole with_____________
Right Ans - PGE1 and PGE2
Why is the use of misoprostol for cervical ripening controversial Right Ans
- + off label warning by manufacturer
+ risk of rupture
The risk of uterine rupture with misoprostol in a non-scarred uterus is
associated with dosages Right Ans - higher than are currently
recommended.
Part of the misoprostol off label use controversy stems from our inability to
Right Ans - answer the question of whether misoprostol used in low doses to
induce labor in women without prior cesareans, is any less safe than other
agents used for the same purpose.
in RCTs with miso and cervadil - Right Ans - serious complications were
rare and there was little difference between the two
FDA warning for miso states: Right Ans - warning was changed in May of
2002 to state that misoprostol is contraindicated for use as an antiulcer drug
in pregnant women.
