Estimated fetal weight more than 3500 g.Post-term pregnancies of more than 40 weeks of gestation.The following were the exclusion criteria: Estimated fetal weight of less than or equal to 3500 g.Primigravida, second, and third gravid women.The following were the inclusion criteria: The patients residing very near to the hospital only were selected to avoid further complications.Īll recruited patients had an early ultrasound for dating of their pregnancy, which was correlated with the expected date of delivery according to the first day of last menstrual period, which was calculated by Naegele's rule to exclude wrong dates. Informed consent was taken from each patient. This prospective study was conducted at El-Mataria Teaching hospital for 9 months between January 2018 and September 2018.īefore initiation of the study, approval was obtained from a convened institutional review board at El-Mataria Teaching Hospital. The aim of the study is to explore the comparative efficacy and safety of the two techniques for cervical ripening/labor induction, that is, stripping of the membrane (mechanical method) and low-dose vaginal misoprostol (pharmaceutical method) on the outcome. The vaginal route reaches a peak after 1–2 h and declines slowly. It can be used either intravaginally or orally and has an excellent half-life (30–60 min). Misoprostol, a PGE1 analog, is used as a medical agent for cervical ripening. The reported adverse effects of membranes stripping are mild bleeding, increase maternal discomfort, and irregular uterine contractions. It leads to an increase in prostaglandin metabolites in maternal circulation and local prostaglandin production. Stripping or sweeping of membranes is defined as the digital separation of the chorioamniotic membranes from the lower uterine segment. ![]() Gestational hypertension, preeclampsia, eclampsia, gestational diabetes, post-term pregnancy, and fetal growth retardation are medical conditions, which need induction of labor. The success of induction depends mostly on the consistency, configuration of the cervix, and compliance of the patient. Mechanical methods include membrane stripping or sweeping and amniotomy, whereas biochemical means include prostaglandin, oxytocin, and laminaria. īoth mechanical and biochemical means are used for cervical ripening and induction of labor. ![]() The method of induction must achieve quick onset of labor, lower incidence of failure, not increase in perinatal morbidity, and also prevent an increase in section (CS) or instrumental delivery rate. Induction of labor is one of the most common procedures in obstetrics, and it is carried out in ∼20% of pregnancies. Stripping of membranes versus vaginal misoprostol in induction of labor. How to cite this URL: Kamal HM, Youssef AM, Elias A. ![]() How to cite this article: Kamal HM, Youssef AM, Elias A. Keywords: Induction-delivery interval, prolonged gestation, stripping of membranes, vaginal misoprostol There were no statistically significant differences between the two groups in the results of neonatal outcome.īoth methods were effective and safe in the induction of labor however, misoprostol needs hospital admission, with no increases in the risk of neonatal outcome and minimal adverse effects. Stripping of membranes is as effective as vaginal misoprostol, but the induction-delivery interval was significantly lower in misoprostol. Outcome data as fetal weight, Apgar scores at 1 and 5 min, and need for admission to neonatal ICU were recorded. Time interval from the start of induction to the delivery time and need for oxytocin augmentation and labor complications were observed. In group II, patients received 25 μg vaginal misoprostol tablets every 6 h with a maximum of four doses after admission for follow-up of fetal well-being and observations of the route of delivery and indication of cesarean section. In group I, stripping of membranes was performed to be repeated after 48 h then followed up within 72 h of the first visit. The study included 100 women divided randomly into two groups: group I ( n = 50) in which stripping of membranes was performed and group II ( n = 50) which received intravaginal misoprostol. This prospective study was conducted for 9 months. This study was done to compare the efficacy and safety of the two techniques for cervical ripening/labor induction by stripping of membranes and low-dose vaginal misoprostol on the outcome of labor induction in singleton pregnancies between 38 and 40 weeks. The objective of this study was to evaluate the safety and efficacy of membrane stripping and vaginal misoprostol in the induction of labor in low-risk patients at term pregnancy (38–40 gestational weeks).
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