Cervical ripening before induction of labour in patients with an unfavourable cervix: A comparative randomized study of the Atad Ripener Device, prostaglandin E(2) vaginal pessary, and prostaglandin E(2) intracervical gel
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AbstractOne hundred and nineteen women with singleton pregnancy and cephalic presentation requiring induction of labour in the presence of an unfavourable cervix (Bishop score less than or equal to 4) were studied. Five patients were excluded because of failure to comply with the protocol. Cervical ripening was carried out using 3 different methods; 36 used the Atad Ripener Device, 39 received 0.5 mg PGE(2) intracervical gel and 39 received at least one 3 mg PGE(2) intravaginal pessary. There were no differences in the demographic characteristics and the indications for induction. Five patients developed complications during the ripening period necessitating intervention; 3 required emergency Caesarean section and 2 delivered vaginally. Although statistically there were no differences among the 3 methods of cervical ripening, the power of the study is probably not large enough to show the differences. The PGE(2) pessary appears to be more effective with 68% of patients either going into labour during cervical ripening or succeeding in the cervical ripening compared to around 50% in the Atad and PGE(2) gel groups. The vaginal delivery rate was 87.2% in the pessary g-roup compared to 72.2% in the Atad group and 84.6% in the gel group. The duration of labour was also shorter in the pessary group with 73.5% delivered within 24 hours compared to 57.7% in the Atad group and 57.6% in the gel group. Although the results of the Atad device seem to be inferior, the risk of uterine hyperstimulation from the use of the device is probably lower than that of the PGE(2) and may therefore be preferable in women with fetuses at high risk of fetal hypoxia.
All Author(s) ListYuen PM, Pang HYY, Chung T, Chang A
Journal nameAustralian and New Zealand Journal of Obstetrics and Gynaecology
Volume Number36
Issue Number3
Pages291 - 295
LanguagesEnglish-United Kingdom
Web of Science Subject CategoriesObstetrics & Gynecology; OBSTETRICS & GYNECOLOGY

Last updated on 2020-17-10 at 02:27