Indication for induction of labour is?

Appeared in: RUHS, Jaipur, M.Sc Nursing Entrance Exam-2021

Explanation

Pregnancy-Induced Hypertension (PIH) at term is a definitive indication for the induction of labor.
The only cure for PIH is the delivery of the fetus and placenta.
Induction is performed to prevent severe maternal complications like eclampsia (seizures) and placental abruption, and to mitigate fetal risks associated with placental insufficiency.

Option B: Placenta previa is an absolute contraindication for labor induction because the placenta covers the cervical os. Uterine contractions and cervical dilation would cause the placenta to detach, leading to catastrophic maternal and fetal hemorrhage.
Option C: Breech presentation is a relative contraindication for induction. The risks, such as umbilical cord prolapse or head entrapment, are significantly increased with induced labor compared to spontaneous labor.
Option D: Significant maternal heart disease is generally a contraindication to induction. The stress of induced contractions can increase cardiac workload and precipitate heart failure.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Indications and Contraindications for Induction of Labor as background academic context rather than a clinical decision trigger.
Before inducing labor, the nurse must assess cervical readiness using the Bishop score. A score of 6 or more is favorable and suggests a higher likelihood of successful induction.
During induction with oxytocin, continuous electronic fetal monitoring (EFM) is crucial to detect signs of fetal distress or uterine tachysystole (more than 5 contractions in 10 minutes).
If uterine tachysystole occurs, the nurse's first action is to stop the oxytocin infusion, turn the patient to her left side, administer oxygen, and notify the provider.

How to Approach the Question

First, understand the question. It asks for an 'indication,' which is a valid medical reason to perform a procedure.
Next, define the procedure in question: 'Induction of labor' is the artificial start of labor.
Evaluate each option to determine if it's a reason FOR or AGAINST inducing labor.
Option A (PIH): This is a high-risk condition where delivery is the cure. This is a strong reason FOR induction.
Option B (Placenta previa): The placenta is blocking the exit. Forcing labor would cause bleeding. This is a reason AGAINST induction (a contraindication).
Option C (Breech): The baby is not head-down. Induction increases risks like cord prolapse. This is a reason AGAINST induction (a contraindication).

Concept Tested & Keywords

QNOszawEuHzo-VCv7dYytk

E6 Midwifery Obstetrics and Gynecology Nursing Sandeep Kaur p. 42-50

Practise the full RUHS, Jaipur, M.Sc Nursing Entrance Exam-2021

Attempt every question from this paper in a timed mock, then review the full solution for each one.