An overview of the various methods of cervical ripening of the unfavorable cervix in women without a prior cesarean delivery is shown in Table 2.
When induction of labor was required, VBAC was not pursued in nonvertex position in 51 hospitals (73%), in an unfavorable cervix in 28 hospitals (40%), in a nonengaged head in 25 hospitals (36%), or in a twin pregnancy in 11 hospitals (16%).
All women had a vertex presentation, intact membranes, and an unfavorable cervix
This randomized controlled trial was conducted in Gynaecology and Obstetrics department of Pakistan Airforce Hospital islamabad from July 2005 and January 2006, Sampling technique used was convenience sampling by lottery method , inclusion criteria was singleton pregnancy of 37 weeks or more with normal cephalic presentation, reassuring fetal status, an unfavorable cervix
(bishop's score less than or = 5), and intact membranes.
ten Eikelder of the department of obstetrics and gynecology at Leiden (the Netherlands) University Medical Center and her associates in 28 other Dutch hospitals, enrolled 1,845 women with a term singleton pregnancy in cephalic presentation, intact membranes, an unfavorable cervix, without prior cesarean section.
"In women with an unfavorable cervix at term, induction of labor with oral misoprostol and Foley catheter are comparable in terms of safety and effectiveness," Dr.
The beneficial effect of induction of labor-in terms of reducing the rate of cesarean delivery-was greater in women who had an unfavorable cervix than in women who had a favorable cervix
* The beneficial effect of induction of labor-in terms of reducing the rate of cesarean delivery--was greater among women who had an unfavorable cervix.
Patients in the PROBAAT trial included women beyond 37 weeks' gestation with a singleton pregnancy in cephalic presentation, with intact membranes and an unfavorable cervix
as defined by a Bishop score less than 6.
Conclusion: Misoprostol is safe for induction of labour with an unfavorable cervix
. The results were satisfying with minimal complications.
Nulliparous women who have an unfavorable cervix
have comparable neonatal and maternal outcomes, including similar rates of cesarean delivery, whether they are managed expectantly or undergo induction of labor
She and her coinvestigators enrolled women with a normal singleton pregnancy at term who had intact membranes and an unfavorable cervix
, with a Bishop score of 5 or less.