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Can we decrease postdatism in women with an unfavorable cervix and a negative fetal fibronectin test result at term
E F Magann1, M F McNamara, N S Whitworth
1Department of Obstetrics and Gynecology, Naval Medical Center, San Diego, California, USA.
American Journal of Obstetrics and Gynecology
|October 28, 1998
Summary
Serial membrane sweeping effectively reduces the risk of postdatism in pregnant individuals with an unfavorable cervix. This method also lowers the need for labor induction, promoting timely delivery.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
Background:
- Postdatism, delivery after 41 weeks, poses risks including the need for postdates induction or antenatal testing.
- Women with an unfavorable cervix and negative fetal fibronectin at 39 weeks are particularly susceptible to postdatism.
Purpose of the Study:
- To evaluate if serial membrane sweeping can decrease the incidence of postdatism in women with specific risk factors at 39 weeks gestation.
Main Methods:
- A randomized controlled trial involving women with uncomplicated pregnancies, an unfavorable cervix, and negative fetal fibronectin at 39 weeks.
- Participants were randomized to either serial membrane sweeping every 3 days or gentle examinations as a control.
Main Results:
- The membrane sweeping group delivered earlier (39.9 weeks) compared to the control group (41.5 weeks).
- Bishop scores were significantly higher in the membrane sweeping group upon admission for delivery.
- No women in the membrane sweeping group required induction for postdatism, unlike 56% in the control group.
Conclusions:
- Serial membrane sweeping is a valuable intervention for women at risk of postdatism.
- This procedure significantly reduces the likelihood of postdatism and the need for labor induction.