Breast stimulation--a new method for induction of cervical ripening in complicated term pregnancies

We have studied the use of breast stimulation as a method of cervical ripening in 75 patients who had complicated term pregnancies and who required induction of labour. The indications for induction were prolonged pregnancy greater than 42 weeks (N = 12), hypertensive disorders of pregnancy (N = 26), suspected intra-uterine growth retardation (N = 30) and a combination of two or more of the above (N = 7). All patients had a modified Bishop score of less than 5 before the start of nine hours of unilateral breast stimulation spread over three days. Twenty-nine out of the 75 patients went into labour during the three day period and, of the remainder, there was a significant improvement in the cervical score of 2.87 +/- 1.99. Three patients, all of whom had prolonged pregnancy, had exaggerated uterine activity. Two patients had foetal heart rate deceleration on antenatal cardiotocography during their first session of breast stimulation but this did not recur in any of their subsequent sessions. No patient had both exaggerated uterine activity and foetal heart rate deceleration. There was no case of perinatal mortality or morbidity.