Induction
How to Schedule an Induction:
Call L&D Triage (for Meriter 608-417-7688, for St Mary's 608-258-6820) and discuss with HUC
Be prepared with patient name, DOB, GA, GP, conditions complicating pregnancy, and indication for induction (Survival Guide - indications for induction)
Identify the attending on call (generally that day and the following day) and send EPIC inbasket message with pt chart and details of induction
Literature:
AFP Cervical Ripening and Labor Induction 2022
ACOG Committee Opinion IOL 2009 (seriously, that looks like the last update)
ACOG Com Opin on Late Preterm/Early Term delivery indications
Powerpoint from fac development 2024 on outpatient cervical ripening
General Information:
Pictocin Protocol for Meriter (from 9/19/21)
PROMMO Study - DON'T FORGET for Meriter pts with PROM
Video of cooks catheter placement
Information on early amniotomy after cervical ripening:
Am J of OBGYN - Early amniotomy 2020
JABFM - "Just Pop It: Early AROM after cervical ripening" 2024
Bottom line for early amniotomy: Does not decrease risk of c-section but reduces interval from induction to delivery
Dilation.pdfCooks Catheter Best Practices:
All first year residents should have an experienced guide when placing a cooks catheter (senior resident or faculty)
For patients with very little dilation consider using a speculum and ring forceps to aid in insertion
May want to consider using dilaudid or other pain control method with insertion to ease patient experience
Consider checking the cooks catheter at 2 hr by deflating the vaginal balloon and assuring that the uterine balloon is appropriately positioned.