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Samenvatting - M7 pathologische arbeid: inductie
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Pathologische arbeidInductie
Inhoudsopgave
HistorIek................................................................................................................................................................1
Mechanisme methoden....................................................................................................................................2
Chirurgische methoden.....................................................................................................................................2
Farmacologische methoden..............................................................................................................................2
KCE richtlijnen inductie..........................................................................................................................................2
Beoordelen inleiding & inleidingsmethodes.........................................................................................................2
Hoe beoordeelt men of cervix rijp is?...............................................................................................................2
Welke methode wordt gekozen?......................................................................................................................3
Inleidingsmethodes...............................................................................................................................................3
Cervixrijping, pre-inductie.................................................................................................................................4
Inductie met syntocinon....................................................................................................................................4
Sweeping of the membranes............................................................................................................................4
Misoprostol & cytotec.......................................................................................................................................5
AMNIOTOMIE....................................................................................................................................................5
Overige..............................................................................................................................................................5
Terminologie.........................................................................................................................................................5
inductie baring...................................................................................................................................................5
Contra indicaties................................................................................................................................................6
Montevideo-eenheden.....................................................................................................................................6
Theobaldmethode.............................................................................................................................................6
Extra-amniotisch................................................................................................................................................6
Intravaginaal......................................................................................................................................................6
Littekenuterus...................................................................................................................................................6
Wat mag een vroedvrouw wettelijk doen.............................................................................................................6
Inductie bij MIU.....................................................................................................................................................6
Actief beleid.......................................................................................................................................................6
Complicatiess prostaglandines..........................................................................................................................7
Mogelijke medicatie ter symptomatische behandeling....................................................................................7
Nazorg...............................................................................................................................................................7
HISTOR IEK
1
, Pathologische arbeid
MECHANISME METHODEN
Dilatatiemethoden vroeger stiften van zeewier die zwellen door vocht
Instilleren van vloeistoffen heet water --> glycerol --> gel
Bougies & ballonnen geplaatst tussen vliezen & uterus
CHIRURGISCHE METHODEN
Amniotomie = vliezen breken
o Hoge katheter van Drew Smyte
o Lage Pozzi
FARMACOLOGISCHE METHODEN
Moederkoren uterus-contraherende eigenschappen
Watson-kuren ricusolie, warm bad & kinine
Oxytocine
Prostaglandines
Aantal inductie daalt ivg met 10j geleden
KCE RICHTLIJNEN INDUCTIE
Voor 39w NIET
Tss 39w-41w NIET
Macrosomie NIET
Vanaf 41w AANVAARDBAAR
Enkel na toestemming van de zwangere!
BEOORDELEN INLEIDING & INLEIDINGSMETHODES
Meer voordelen dan nadelen? Littekenuterus, zwangerschapsduur & toestand kind
Vaginaal of abdominaal?
Hoe kunnen we dit bereiken?
Risico’s inductie
Preterme bevalling na foute duurberekening
Failed induction
Hypercontractiliteit of *tetanie uterus
Foetale nood tgv tetanie
40% inducties eindigt in kunstverlossing
*tetanie uterus
= krampen spier
HOE BEOORDEELT MEN OF CERVIX RIJP IS?
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