Membrane sweeping versus dinoprostone vaginal insert in the management of pregnancies beyond 41 weeks with an unfavorable cervix.
OBJECTIVE
To determine the best method of cervical ripening to prevent postdate inductions in women with an unfavorable cervix at 41 weeks' gestation.


METHODS
Women presenting at 41 weeks' gestation with a Bishop score of < or = 4 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 < 0.001), had less time elapsed from admission to delivery (p = 0.018), and had fewer labor inductions at 42 weeks (p = 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 = 0.006) than in group I. Total antenatal costs for the membrane sweeping group was $15,120 versus $59,540 for the dinoprostone group.


CONCLUSIONS
Daily membrane sweeping was more effective than dinoprostone administration with fewer postdate inductions at one-fourth the cost.
Magann
E F
EF
University of Mississippi Medical Center, Department of Obstetrics and Gynecology, Jackson 39216-4505, USA.
Chauhan
S P
SP
McNamara
M F
MF
Bass
J D
JD
Estes
C M
CM
Morrison
J C
JC
D000328:Adult; D020070:Cervical Ripening; D015232:Dinoprostone / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D010120:Oxytocics / Q000627:therapeutic use*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies; D013488:Suppositories
D010120:Oxytocics; D013488:Suppositories; D015232:Dinoprostone