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Key Points

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Key Points

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Key Points

  • First or second trimester ultrasound provides more accurate dating than even a 'certain' last menstrual period
  • Establishing an expected date of delivery by scan dates alone (vs 7, 10 or 14 day 'rules') reduces unnecessary inductions for postdate pregnancy
  • There appears to be little clinical benefit in using more than one dose of prostaglandin
  • Misoprostol promises to be an effective induction agent but its introduction has to await a large RCT
  • Uterine hyperstimulation is often underdiagnosed.
  • Formal guidelines are needed, which should include the immediate stopping of oxytocin.
  • There may be a place for tocolytics
  • Reliance on technology - e.g. tocograph monitoring - should not lead to us ignoring our basic clinical skill

IOL Perinatal Forum - Recommendations for current practice:

1. pregnancy dating should be by ultrasound scan alone
2. beware of uterine hyperstimulation!
3. there is an urgent need for induction and hyperstimulation protocols.

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© Perinatal Institute 2005