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Induction and Augmentation of Labor

A 19-year-old primigravida presents to the labor and delivery unit with the complaint of contractions following spontaneous rupture of membranes. Her initial cervical exam shows she is 2 cm dilated; 3 hours later she is 5 cm dilated. Over the next 4 hours there is no further cervical dilation, and oxytocin is started. The use of oxytocin in this setting would be described as which of the following?

a. Labor induction

b. Cervical ripening

c. Uterine maturation

d. Labor augmentation

A 19-year-old primigravida presents to the labor and delivery unit with the complaint of contractions following spontaneous rupture of membranes. Her initial cervical exam shows she is 2 cm dilated; 3 hours later she is 5 cm dilated. Over the next 4 hours there is no further cervical dilation. Which of the following methods of uterine stimulation could be employed?

a. Oxytocin

b. Misoprostol

c. Dinoprostone

d. Extraamnionic saline infusion

Which of the following complications is increased in the setting of labor induction?

a. NICU admission

b. Postpartum hemorrhage

c. Amnionic fluid embolus

d. Umbilical artery pH <7.0

A 36-year-old G5P2 at 39 weeks’ gestation presents for labor induction. Her previous largest infant weighed 3500 grams. She had a prior vertical cesarean section for a preterm breech presentation at 27 weeks’ gestation, and has a history of herpes simplex type 1 infection. Which of the following is the correct first step in her evaluation for the appropriateness of labor induction?

a. Ultrasound for estimated fetal weight

b. Digital cervical exam to determine Bishop score

c. Speculum exam to look for herpes simplex lesions

d. None of the above

A 36-year-old G5P2 at 39 weeks’ gestation presents for labor induction. Her previous largest infant weighed 3500 grams. She had a prior vertical cesarean section for a preterm breech presentation at 27 weeks’ gestation. The ...

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