Methods for cervical ripening and induction of labor.
Induction of labor is common in obstetric practice. According to the most current studies, the rate varies from 9.5 to 33.7 percent of all pregnancies annually. In the absence of a ripe or favorable cervix, a successful vaginal birth is less likely. Therefore, cervical ripening or preparedness for induction should be assessed before a regimen is selected. Assessment is accomplished by calculating a Bishop score. When the Bishop score is less than 6, it is recommended that a cervical ripening agent be used before labor induction. Nonpharmacologic approaches to cervical ripening and labor induction have included herbal compounds, castor oil, hot baths, enemas, sexual intercourse, breast stimulation, acupuncture, acupressure, transcutaneous nerve stimulation, and mechanical and surgical modalities. Of these nonpharmacologic methods, only the mechanical and surgical methods have proven efficacy for cervical ripening or induction of labor. Pharmacologic agents available for cervical ripening and labor induction include prostaglandins, misoprostol, mifepristone, and relaxin. When the Bishop score is favorable, the preferred pharmacologic agent is oxytocin.
Tenore
Josie L
JL
Department of Family Medicine, Northwestern University Medical School, Chicago, Illinois 60611, USA. josietenore@hotmail.com
D020070:Cervical Ripening / Q000187:drug effects*; D002584:Cervix Uteri / Q000187:drug effects; D015232:Dinoprostone / Q000627:therapeutic use; D005260:Female; D006727:Hormone Antagonists / Q000627:therapeutic use; D006801:Humans; D007751:Labor, Induced / Q000379:methods*; D015735:Mifepristone / Q000627:therapeutic use; D016595:Misoprostol / Q000627:therapeutic use; D010120:Oxytocics / Q000627:therapeutic use*; D011247:Pregnancy; D016032:Randomized Controlled Trials as Topic; D014590:Uterine Contraction / Q000187:drug effects*
D006727:Hormone Antagonists; D010120:Oxytocics; D016595:Misoprostol; D015735:Mifepristone; D015232:Dinoprostone