Effect of Coital Activity on Onset of Labor in Women Scheduled for Labor Induction: A Randomized Controlled Trial

Abstract

Coital activity at term reportedly is associated with shorter gestation and less need to induce labor because of prolonged pregnancy, but such findings have not been consistently affirmed. In this randomized study, 108 women scheduled to have nonurgent induction of labor at term (37 weeks' gestation or later) were randomly assigned to be advised to have vaginal intercourse with the goal of hastening the onset of labor. They were told that intercourse late in pregnancy was safe and could promote the onset of labor. The 102 women in a control group were neither encouraged nor discouraged to have coitus. Labor was induced by amniotomy if the cervix was favorable and by vaginal dinoprostone if it was unfavorable. All participants kept a coital and orgasm diary and received standard obstetrical care.The rate of reported coital activity was 60% in women advised to have sex and 40% in control women; the relative risk was 1.5, with a 95% confidence interval of 1.1 to 2.0. Nevertheless, rates of spontaneous labor did not differ significantly; they were 56% in the study group and 52% in control women. More than 80% of women who reported one or more episodes of vaginal sex after randomization also reported having at least one orgasm. The 2 groups did not differ significantly with regard to either the timing of admission for birth or spontaneous labor, or presentation at admission for birth. There also were no group differences in rates of cesarean delivery, maternal fever, or neonatal outcomes.These findings do not validate the practice of advising women scheduled for induction of labor at term to have vaginal intercourse in order to hasten the onset of labor. ABSTRACTAlthough treating cervical weakness after dilation has rescued many pregnancies, there is a trend toward performing cerclage before the cervix has begun dilating, and this requires a diagnostic test to confirm cervical weakness. This observational study measured the cervical resistance index (CRI)-the force required to dilate the cervix to 8 mm-as an aid in choosing which women with a history of spontaneous mid-trimester miscarriage should have cervical cerclage in subsequent pregnancies. The study group included 175 nonpregnant women with a history of one or more spontaneous mid-trimester losses at 12 to 28 weeks' gestation, and the control group comprised 123 nonpregnant women having CRI measurements during routine gynecological surgery. Women whose CRI indicated an incompetent cervix were advised to have cervical cerclage in future pregnancies. A CRI below 5 lb, or 22 Newtons (N), was taken as an indicator of cervical weakness.The study and control women had median CRI values of 17 and 38 N, respectively. Thirty study women were considered to have a competent cervix by CRI while the obstetrical history suggested otherwise. At the same time, 32 ABSTRACTBecause little is known about repeat laparotomy in the early postoperative period following cesarean section-one of the least frequent short-term complications-the investigators reviewed 3380 women having cesa...

Coitus to expedite the onset of labour: a randomised trial

“…Although human ejaculate weakens chorioamniotic membranes, 15 the association of sexual intercourse in late pregnancy and PROM is not consistently reported. [16][17][18] Our study showed no significant difference in PROM (16.4 versus 13.4%; P = 0.25) between the groups, similar to a previous trial report, 9 and consistent with another study that concluded that there were no sexual positioning or sexual activities that were significantly related to PROM. 19 In our present study, there was no significant difference in length of labour, need of oxytocin, mode of delivery, postpartum haemorrhage, Apgar score at 5 minutes, cord arterial blood pH, admission to neonatal unit and perinatal mortality across the trial arms.…”

“…This effect is consistent with the results of a previous trial that investigated advising coitus to women scheduled for a non-urgent labour induction, which reported rates of coitus of 60.2 versus 39.6% (RR 1.5, 95% CI 1.1-2.0, P = 0.004) in the advised-coitus versus control arms, respectively. 9 The frequency of reported coital activity was also higher in the advise-coitus group in the current trial. These findings demonstrate that coital activity at term can be influenced by medical advice.…”

“…However, despite the increase in reported coitus, there was no observed impact on the onset of labour or the labour induction rate in our current trial or in the earlier trial. 9 This lack of correlation between reported coitus and downstream outcome of labour onset is also reported by a prospective study. 12 We specifically targeted women who were recently abstinent from coitus in the anticipation that any advice promoting coitus would have the greatest impact within this group of women as they started from a zero base in coital activity, and that abstinent controls would largely continue to be abstinent by inclination.…”

“…The methodology and intervention for this trial is adapted from and closely mirrored that of an earlier trial performed at our centre on advising coitus in women scheduled for a non-urgent induction of labour. 9 We decided to proceed with this trial as the proposed study population and circumstances are widely divergent from those of the earlier trial, 9 and a prospective study of coitus from 36 weeks of gestation onwards, also carried out at our centre with a similar study population and circumstances, has shown a strong correlation between coitus and the onset of labour. 5 The groundwork and funding for this trial was in place before the non-significant result of the earlier trial was reported.…”

Sexual Activity during Pregnancy in Childbirth and after Childbirth

“…Preterm delivery was no more frequent in those having intercourse than in those abstaining. Chiong Tan et al [60] wanted to determine coital incidence at term and to estimate its effect on labour onset and mode of delivery. They analysed 200 healthy women with uncomplicated pregnancies who kept a diary of coital activity from 36 weeks of gestation until birth and answered a short questionnaire.…”