Originally Posted by wannabe  "if a woman is booked for prostin induction but has a favourable cervix on the Bishops score (usually a multip i.e has already given birth) then instead of prostin induction you may here the term "she is ARMable" thus meaning they will take her to delivery suite to perform this."
Is this consistent with evidence on whether prostin can be used in women with favourable cervix? (see current NICE guidelines on induction of labour, and consultation draft of NICE guidelines due out in June).
Does the term ARMable imply that ARM is necessary, or merely possible?
What are the implications for labour of induction by ARM (& oxytocin) versus prostin?
Should women have a choice of induction method where there are two possible alternatives? |
Good points, as usual wannabe
... ARMable is a term loosley thrown around in my Trust, it always seems to me to mean that an ARM is possible not neccessarily required or even indicated. Augmentation to save time perhaps... hand in hand with use of syntometrine...
Your point about prostin vs ARM & oxytocin reminded me about a discussion with other students re Dr vs Midwife 'prostin ve's' as they have been called.... our midwives are very careful, gentle and inform the women exactly what they are doing as they locate the posterior fornix and insert the prostin gel. Whereas Drs (Im not generalising but in the cases we were talking about in our Trusts) some Drs seem a bit bish bash bosh job done. Is it that they have more experience with augmenting labour via prostin insertion or sloppy practice? how can they be sure the gel is in the posterior fornix so quickly? or are they shots in the dark? anyone else witnessed this?