O&G Cases · Antenatal care — timing of birth
Post-term at 41+5 — communication and counselling station
Communication and shared-decision-making station: a capable, informed woman declining induction at post-term gestation. Tests risk literacy, balanced counselling, respect for autonomy, enhanced-surveillance planning, safety-netting, documentation, and the communication domains. Includes assessor key and marking domains.
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Target exams
Station brief
Format. Communication and shared-decision-making station, approximately 12 minutes. You are the antenatal clinic registrar. The assessor plays the woman (and feeds new information). The consultant is available for discussion. [3]
Candidate instruction. Conduct the post-term counselling conversation. Confirm her understanding is complete and her decision is informed, explore her reasons, present the options and the evidence in absolute terms, agree a plan that respects her autonomy, and arrange appropriate surveillance and safety-netting. Document the discussion. [3]
References4ShowHide
- [1]Muglu J, Rather H, Arroyo-Manzano D, et al. Risks of stillbirth and neonatal death with advancing gestation at term: a systematic review and meta-analysis of cohort studies of 15 million pregnancies PLoS Med, 2019.PMID 31265456
- [2]Gülmezoglu AM, Crowther CA, Middleton P, Heatley E Induction of labour for improving birth outcomes for women at or beyond term Cochrane Database Syst Rev, 2012.PMID 22696345
- [3]Keulen JKJ, Bruinsma A, Kortekaas JC, van Dillen J, et al. Timing induction of labour at 41 or 42 weeks? A closer look at time frames of comparison: a review Midwifery, 2018.PMID 30170263
- [4]Finucane EM, Murphy DJ, Biesty LM, et al. Membrane sweeping for induction of labour Cochrane Database Syst Rev, 2020.PMID 32103497