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Obstetric and Neonatal Outcomes of Using Mechanical Methods in Cases of Pregnancy Requiring Cervical Ripening
Nobuko Yokoyama1, Shunji Suzuki1
1Department of Obstetrics and Gynecology, Japanese Red Cross Katsushika Maternity Hospital, Tokyo, Japan.
Introduction:
We examined the obstetric and neonatal outcomes of using mechanical methods (i.e., insertion of Dilapan as the synthetic equivalent in the cervical canal) for cervical ripening in cases with premature rupture of the membranes (PROMs) at term.
Methods:
The criteria for inclusion in this retrospective observational study were as follows: PROM, singleton pregnancy, cephalic presentation, gestational age of 37-41 weeks, and a Bishop score of 0-2 at the beginning of induction. During the study period, 85 women met the criterion, and mechanical methods were used for cervical ripening following PROM. We examined the rate of cesarean delivery, number of days from the start of induction to delivery, umbilical artery pH, the incidence of clinical intrauterine infection, and neonatal infection.
Results:
In cases of using mechanical methods following PROM at term, the number of days from the start of induction to delivery was 2.1 ± 2 days. The rate of cesarean delivery was 26% (22/85). The incidence of clinical intrauterine infection during labor was 7% (6/85), while there were no cases of neonatal infection. In addition, the incidence of maternal fever after the third postoperative day was 1% (1/85).
Conclusions:
The current results suggest the potential clinical utility of mechanical cervical ripening methods following PROM at term.
