Management of post-date pregnancies with unfavorable cervix in primigravida

ABSTRACT

To determine the best management of pregnancy beyond 41 weeks, with an unfavorable cervix for induction in primigravida. Two hundred and six pregnant women with uncomplicated pregnancies that reached 41 week gastation with unfavorable cervix [Bishop Score < 4]; cephalic presentation were randomly allocated into two group. First group, the study group underwent daily placement of prostaglandin pessary until 42 weeks. While in the second group daily cervical examination and assessment took place. Study and control group ratio was 11. The date confirmed by ultrasound early bookig. In the study group, ninety-three patients [90.3%] had successful outcome after one or two prostaglandin pessaries. Ten patients [9.7%] reached 42 weeks of gestation without any cervical changes. In the control group, seventy-three patients [70.9%] reached 42 weeks of gestation without any cervical changes [the same Bishop Score], while thirty patients [29.1%] had spontaneous labor. Daily placement of a prostaglandin pessary is successful in reducing the number of inductions of labor at 42 weeks for post-term pregnancies