Oestrogens alone or with amniotomy for cervical ripening or induction of labour

Thomas, Justin; Kelly, Anthony; Kavanagh, Jennifer

doi:10.1002/14651858.cd003393

Cited by 49 publications

(15 citation statements)

References 46 publications

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“…The local application of estrogen for the induction of labour has been tried,45 and estrogen does enhance cervical ripening 46. However, estrogens appear to be less effective than prostaglandins for the induction of labour and delivery, and there are insufficient data to draw any conclusions 47. The effect of estrogen alone on cervical ripening in postmenopausal women has not been investigated previously.…”

Section: Discussionmentioning

confidence: 99%

A combination of misoprostol and estradiol for preoperative cervical ripening in postmenopausal women: a randomised controlled trial

Oppegaard

Lieng

Berg

et al. 2009

BJOG

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ObjectiveTo compare the impact of 1000 μg of self-administered vaginal misoprostol versus self-administered vaginal placebo on preoperative cervical ripening after 2 weeks of pretreatment with estradiol vaginal tablets in postmenopausal women prior to day-care operative hysteroscopy.DesignRandomised, double-blind, placebo-controlled sequential trial.SettingNorwegian university teaching hospital.PopulationSixty-seven postmenopausal women referred for day-care operative hysteroscopy.MethodsThe women were randomised to receive either 1000 μg of self-administered vaginal misoprostol or self-administered vaginal placebo on the evening before day-care operative hysteroscopy. All women had administered a 25-μg vaginal estradiol tablet daily for 14 days prior to the operation.Main outcome measuresPrimary outcome: preoperative cervical dilatation at hysteroscopy. Secondary outcomes: difference in dilatation at recruitment and before hysteroscopy, number of women who achieved a preoperative cervical dilatation of 5 mm or more, acceptability, complications and adverse effects.ResultsThe mean cervical dilatation was 5.7 mm (SD, 1.6 mm) in the misoprostol group and 4.7 mm (SD, 1.5 mm) in the placebo group, the mean difference in cervical dilatation being 1.0 mm (95% CI, 0.2–1.7 mm). Self-administered vaginal misoprostol of 1000 μg at home on the evening before day-care hysteroscopy is safe and highly acceptable, although a small proportion of women experienced lower abdominal pain.ConclusionsOne thousand micrograms of self-administered vaginal misoprostol, 12 hours prior to day-care hysteroscopy, after 14 days of pretreatment with vaginal estradiol, has a significant cervical ripening effect compared with placebo in postmenopausal women.

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Section: Discussionmentioning

confidence: 99%

A combination of misoprostol and estradiol for preoperative cervical ripening in postmenopausal women: a randomised controlled trial

Oppegaard

Lieng

Berg

et al. 2009

BJOG

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“…A systematic review determined the lack of data leading to definitive conclusions, nevertheless the studies analyzed do not indicate differences between women using estrogens for cervical ripening when compared to women using placebo. 18 The role of corticosteroids in the labor process is not well known yet. Classical experimental studies indicated the value of cortisol secretion by the fetal adrenal gland to the onset of parturition in lambs.…”

Section: Methods Of Cervix Ripeningmentioning

confidence: 99%

Cervical ripening methods for labor induction

Surita

Cecatti

Kruppa

et al. 2004

Rev. Bras. Saude Mater. Infant.

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“…However, on a whole there were insufficient data to draw any conclusions regarding the efficacy of estrogen as an induction agent, given small, differing trials with different controls and different outcomes reported (86).…”

Section: Estrogenmentioning

confidence: 99%