please can you explain the background reasoning to this question too. I was under the impression induction for previous precipitate labour was to be avoided but regardless, starting Synto without rupturing membranes was also to ideally be avoided.
Many thanks
Options for Questions 24-24
A
No additional intervention at this stage
B
Deliver by caesarean section
C
Evacuation of retained products of conception
D
Artificial rupture of membranes
E
Commence iv oxytocin regimen
F
Venous access and resuscitation
G
Controlled artificial rupture of membranes in theatre
H
Intra-muscular analgesia
I
Prostaglandin induction of labour
J
Manual replacement of the uterus
K
Sub-cutaneous terbutalline
L
Delay induction of labour
Instrunctions:For each of the case histories described below, choose the single most appropriate management from the above list. Each option may be used once, more than once, or not at all.
Explanation
Question 24
A 34 year old woman with four previous vaginal deliveries has been admitted for induction of labour at 40 weeks gestation because she has a history of precipitate labours with her last baby being delivered in the car. The fetal head is five fifths palpable and the cervix is 2cm long, soft and posterior with a multiparous os. The presenting part is not reached on vaginal examination.
query regarding same question as above.
Posted by SHABANA A.
Dear Paul.
I have come across a same EMQ(no18) as above in a book MRCOG 2,A STRUCTURED APPROACH by Pranathi Reddy n Uma Ram and according to them the answer is L i.e. delay induction in labour.
Their explanation is- No additional intervention is needed as she seems to be getting into spontaneous labour on her own.
According to NICE guideln IOL shoud be offered b/w 41-42 weeks, so why she is induced at 40weeks?why can't we wait until 41 weeks?Please explain .
