Management of pregnancies beyond forty-one weeks' gestation with an unfavorable cervix

Magann, Everett F.; Chauhan, Suneet P.; Nevils, Bobby G.; McNamara, Michael F.; Kinsella, Mary J.; Morrison, John C.

doi:10.1016/s0002-9378(98)70334-5

Cited by 39 publications

(21 citation statements)

References 18 publications

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“…Recently, several studies reported the effectiveness of sweeping of the fetal membranes in reducing the incidence of prolonged pregnancies and the length of term gestations [5,6,12,13]. On the contrary, other authors reported that sweeping of the fetal membranes does not significantly increase the proportion of women who begin spontaneous labor [4,7,13,14].…”

Section: Discussionmentioning

confidence: 99%

Sweeping of the Membranes versus Uterine Stimulation by Oxytocin in Nulliparous Women

Salamalekis¹,

Vitoratos²,

Kassanos³

et al. 2000

Gynecol Obstet Invest

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The aim of this study was to evaluate whether sweeping of the membranes at term could shorten the length of pregnancy and reduce the incidence of postterm pregnancies. We randomly selected 104 nulliparas with uncomplicated pregnancy and gestational age between 281 and 287 days. Our patients were divided into three groups. Group A consisted of 34 women who were subjected to sweeping of the membranes. Uterine stimulation with oxytocin was applied in 35 women (group B), and 35 women (group C) were used as a control group. We had no significant reduction of the time interval from sweeping of the membranes until delivery (1.9 ± 1.2 days), compared to that of group B (2.1 ± 0.8 days) as well as that of the control group (2.5 ± 0.9 days). The incidence of spontaneous labor in patients after sweeping of the membranes was greater (67.6%) when compared with oxytocin-stimulated patients and the control group (p < 0.05). Furthermore, a better Bishop score was noted in patients of group A. No statistically significant difference was noted in the mode of delivery between the groups, but sweeping of the membranes significantly decreased the incidence of postterm pregnancies (p < 0.05). We concluded that sweeping of the membranes is an effective method for initiating labor in women with a gestational age between 40 and 41 weeks, thus reducing the need for induction.

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Section: Discussionmentioning

confidence: 99%

Sweeping of the Membranes versus Uterine Stimulation by Oxytocin in Nulliparous Women

Salamalekis¹,

Vitoratos²,

Kassanos³

et al. 2000

Gynecol Obstet Invest

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“…The success of the sweeping in our study may be influenced by the cervical unfavorability at the start (Bishop Յ 4) shown in other studies 8,9 and the frequency of the sweeping, which was done daily. Clearly, the low 4% induction rate in the membrane stripping group, when compared with a control group of women with similar Bishop scores at 41 weeks who did not have membrane sweeping or any other type of cervical ripening rate of 63% at 42 weeks, 4 is evidence suggestive of the success of daily membrane sweeping.…”

Section: Commentmentioning

confidence: 91%

“…These calculations are based on a previous study in which 17% of patients with an unfavorable cervix treated with daily membrane stripping would remain undelivered for another 7 days. 4 Statistical analysis was performed by Student's t, -squared, and Fisher's exact tests where appropriate, and p Ͻ 0.05 was considered significant.…”

Section: Methodsmentioning

confidence: 99%

“…It has been observed that, in women beyond 41 weeks with an unfavorable cervix, 63% will remain undelivered 7 days later without cervical ripening. 4 However, the membrane sweeping technique resulted in fewer 42-week inductions (4% vs 14%) with the Cervidil without an increase in the risks of complications attributed to membrane sweeping, which include rupture of the membranes, bleeding, or infection. The risk of infection and membrane rupture occurred more frequently in the Cervidil group, although it was not significantly different from the membrane sweeping group.…”

Section: Commentmentioning

confidence: 99%

“…2,3 Of women presenting with a Bishop score of Յ4 at 41 weeks, 63% will remain undelivered at 42 weeks' gestation. 4 Dinoprostone (prostaglandin E 2 ) has been beneficial when used for preinduction cervical ripening in a variety of medical conditions. 5 Dinoprostone vaginal inserts (Cervidil; Forest Pharmaceuticals, St. Louis, MO) commercially offer the advantages of a slow, reproducible release preparation (0.3 mg/hr over 12 hours) and a retrieval system that permits removal of the insert if hyperstimulation occurs.…”

mentioning

confidence: 99%

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Membrane Sweeping versus Dinoprostone Vaginal Insert in the Management of Pregnancies beyond 41 Weeks with an Unfavorable Cervix

et al. 1999

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OBJECTIVE:To determine the best method of cervical ripening to prevent postdate inductions in women with an unfavorable cervix at 41 weeks' gestation. STUDY DESIGN:Women presenting at 41 weeks' gestation with a Bishop score of Յ4 received daily dinoprostone (Cervidil) vaginal inserts (group I) or daily membrane sweeping (group II). RESULTS:One-hundred and eighty-two women were prospectively randomized with 91 women in each arm. The women in group II, membrane sweeping, had Bishop scores significantly greater on admission for delivery (p Ͻ 0.001), had less time elapsed from admission to delivery (p ϭ 0.018), and had fewer labor inductions at 42 weeks (p ϭ 0.04) than the women in group I, the dinoprostone group. In addition, a greater number of women in group II were admitted in spontaneous labor (p ϭ 0.006) than in group I. Total antenatal costs for the membrane sweeping group was $15,120 versus $59,540 for the dinoprostone group. CONCLUSION:Daily membrane sweeping was more effective than dinoprostone administration with fewer postdate inductions at one-fourth the cost.Postterm pregnancy, with a reported frequency of 3% to 12%, 1 is a gestation extending beyond 42 weeks (294 days from the last menstrual period). These gestations may be complicated by oligohydramnios, meconium-stained amniotic fluid, macrosomia, fetal dysmaturity syndrome, and perinatal death.2,3 Of women presenting with a Bishop score of Յ4 at 41 weeks, 63% will remain undelivered at 42 weeks' gestation.

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Membrane sweeping for induction of labour

Boulvain¹,

Stan

Irion³

2005

Cochrane Database of Systematic Reviews

182

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Management of pregnancies beyond forty-one weeks' gestation with an unfavorable cervix

Cited by 39 publications

References 18 publications

Sweeping of the Membranes versus Uterine Stimulation by Oxytocin in Nulliparous Women

Sweeping of the Membranes versus Uterine Stimulation by Oxytocin in Nulliparous Women

Membrane Sweeping versus Dinoprostone Vaginal Insert in the Management of Pregnancies beyond 41 Weeks with an Unfavorable Cervix

Membrane sweeping for induction of labour

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