KHUH

NICE

WHO

ACOG

SOGC

FOGSI

Queensland

Counseling

-Reason for IOL

-Potential risks and benefits of IOL

-Setting and method

-Arrangements for support and pain relief

-Alternative options if refusing IOL

-Subsequent plan if failed IOL

-Reason/indication for IOL

-Risk of complications

-Indication of IOL

-Risks/benefits of IOL

-Methods of IOL, advantages and disadvantages

-Pain relief

-Options available if unsuccessful IOL or refusing IOL

NA

-Agents and methods for IOL

-Electronic equipment used for monitoring

-Expected duration of labour

-Support system available during labour

-Consider needs and preferences of patient

-Allow time for questions and decision-making

-Document discussion including its outcome

Assessment

-Confirm GA

-Review antenatal record

-Perform clinical examination

-Evaluate cervical status

-Document indication for IOL

Assess and document cervical status

NA

-Consider GA (confirmed by ultrasound in 1^st trimester) and parity

NA

-Assess membranes

-Assess fetal wellbeing with CTG

-Consider urgency for IOL

NA

-Assess pelvis, fetal size and presentation

-Consider risks to mother or fetus

-Document indication, reason and method of induction

-Review maternal history

-Consider indication and rule out contraindications

-Reliable estimation of GA, presentation and fetal weight

-Record maternal vital signs and abdominal palpation findings to confirm lie, position and engagement

-Assess cervical status

-Document indication, modified Bishop score and GA

Abbreviations: NA: not applicable; IOL: induction of labour; GA: gestational age; CTG: cardiotocograph