title: Breast stimulation in low-risk primigravidas at term: does it aid in spontaneous onset of labour and vaginal delivery? A pilot study.
abstract: OBJECTIVE
  The aim of the study was to elicit the safety and efficacy of breast stimulation as an intervention to prevent postdatism and as an aid in spontaneous onset of labour.
  
  
  METHODS
  Primigravidas with cephalic presentation, without any high-risk factor, were recruited between 36 to 38 weeks of gestation. 200 patients were recruited and randomized into two groups (n = 100). Breast stimulation was advised to one group but not to the other group. Bishop's scoring was done at 38 weeks and repeated at 39 weeks of gestation. Maternal and fetal outcomes were compared in two groups.
  
  
  RESULTS
  Bishop's score changed from 3.12 (±1.01) to 3.9 (±1.08) in control group and from 3.02 (±0.82) to 6.08 (±1.29) in breast stimulation group after one week (P value < 0.0001). The period of gestation at delivery was 39.5 (±2.3) weeks in control group and 39.2 (±2.8) weeks in intervention group (P value: 0.044). There were increased chances of vaginal delivery in intervention group (P value: 0.046). Duration of labor, hyperstimulation, presence of meconium stained liquor, postpartum hemorrhage, and neonatal outcomes were similar in both groups.
  
  
  CONCLUSIONS
  Breast stimulation in low-risk primigravidas helps in cervical ripening and increases chances of vaginal delivery.
authors.affiliation: Department of Obstetrics and Gynaecology, Maulana Azad Medical College and Associated Lok Nayak Hospital, Bahadur Shah Zafar Marg, Delhi Gate, New Delhi 110002, India.
authors.forename: Nilanchali
authors.identifier: 0000-0002-4141-8441
authors.initials: N
authors.lastname: Singh
authors.affiliation: Department of Obstetrics and Gynaecology, Maulana Azad Medical College and Associated Lok Nayak Hospital, Bahadur Shah Zafar Marg, Delhi Gate, New Delhi 110002, India.
authors.forename: Reva
authors.initials: R
authors.lastname: Tripathi
authors.affiliation: Department of Obstetrics and Gynaecology, Maulana Azad Medical College and Associated Lok Nayak Hospital, Bahadur Shah Zafar Marg, Delhi Gate, New Delhi 110002, India.
authors.forename: Yedla Manikya
authors.initials: YM
authors.lastname: Mala
authors.affiliation: Department of Obstetrics and Gynaecology, Maulana Azad Medical College and Associated Lok Nayak Hospital, Bahadur Shah Zafar Marg, Delhi Gate, New Delhi 110002, India.
authors.forename: Niharika
authors.identifier: 0000-0002-6992-4274
authors.initials: N
authors.lastname: Yedla
mesh_terms: D000328:Adult; D001940:Breast / Q000502:physiology*; D020070:Cervical Ripening / Q000502:physiology*; D002585:Cesarean Section; D036861:Delivery, Obstetric; D005260:Female; D020073:Gravidity; D006801:Humans; D008405:Massage / Q000379:methods*; D010865:Pilot Projects; D011247:Pregnancy; D011256:Pregnancy Outcome; D012307:Risk Factors