Outpatient management of the uncomplicated postdate pregnancy with intravaginal prostaglandin E2 gel and membrane stripping

Doany, Waleed; McCarty, Julie

doi:10.1002/(sici)1520-6661(199703/04)6:2<71::aid-mfm2>3.3.co;2-z

Cited by 4 publications

(5 citation statements)

References 14 publications

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“…A number of studies focused on interventions that we had either specifically excluded (e.g. Doany 1997; Kaul 2004; Magann 1999; and Salamalekis 2000 looked at membrane sweeping), or interventions that are not used nowadays in clinical practice (extra amniotic saline infusion was examined by Moghtadaei 2007; it was not clear that women in both arms of this trial were discharged home; Spallicci 2007 examined the use of hyaluronidase injection).…”

Section: Resultsmentioning

confidence: 99%

“…It was not clear that this was a RCT Damania 1992 In this study breast stimulation was compared with an oxytocin infusion. It was not clear that women in the oxytocin group were discharged home Di Lieto 1989 This study used a crossover design. Doany 1997 In this study intravaginal PGE2 with or without membrane sweeping was compared with placebo with or without membrane sweeping. Complex interventions or interventions involving membrane sweeping are not included in this review Dorfman 1987 In this study women received a range of homeopathic herbal preparations versus placebo.…”

Section: Characteristics Of Included Studies [Ordered By Study Id]mentioning

confidence: 99%

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Different methods for the induction of labour in outpatient settings

Dowswell¹,

Kelly²,

Livio³

et al. 2010

Cochrane Database of Systematic Reviews

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Background Induction of labour is carried out for a variety of indications and using a range of pharmacological, mechanical and other methods. For women at low risk, some methods of induction of labour may be suitable for use in outpatient settings. Objectives To examine pharmacological and mechanical interventions to induce labour in outpatient settings in terms of feasibility, effectiveness, maternal satisfaction, healthcare costs and, where information is available, safety. The review complements existing reviews on labour induction examining effectiveness and safety. Search methods We searched the Cochrane Pregnancy and Childbirth Group’s Trials Register (December 2009) and reference lists of retrieved studies. Selection criteria We included randomised controlled trials examining outpatient cervical ripening or induction of labour with pharmacological agents or mechanical methods. Data collection and analysis Two authors independently extracted data and assessed eligible papers for risk of bias. We checked all data after entry into review manager software. Main results We included 28 studies with 2616 women examining different methods of induction of labour where women received treatment at home or were sent home after initial treatment and monitoring in hospital. Studies examined vaginal and intracervical PGE2, vaginal and oral misoprostol, isosorbide mononitrate, mifepristone, oestrogens, and acupuncture. Overall, the results demonstrate that outpatient induction of labour is feasible and that important adverse events are rare. There was no strong evidence that agents used to induce labour in outpatient settings had an impact (positive or negative) on maternal or neonatal health. There was some evidence that, compared to placebo or no treatment, induction agents reduced the need for further interventions to induce labour, and shortened the interval from intervention to birth. We were unable to pool results on outcomes relating to progress in labour as studies tended to measure a very broad range of outcomes. There was no evidence that induction agents increased interventions in labour such as operative deliveries. Only two studies provided information on women’s views about the induction process, and overall there was very little information on the costs to health service providers of different methods of labour induction in outpatient settings. Authors’ conclusions Induction of labour in outpatient settings appears feasible. We do not have sufficient evidence to know which induction methods are preferred by women, or the interventions that are most effective and safe to use in outpatient settings.

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Section: Resultsmentioning

confidence: 99%

Section: Characteristics Of Included Studies [Ordered By Study Id]mentioning

confidence: 99%

Different methods for the induction of labour in outpatient settings

Dowswell¹,

Kelly²,

Livio³

et al. 2010

Cochrane Database of Systematic Reviews

View full text Add to dashboard Cite

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“…The results of trials on the effectiveness of membrane sweeping have been inconsistent, [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] possibly due to methodological differences between studies. 7 Routine use of membrane sweeping between 38 and 40 weeks does not seem to produce clinically important benefits according to a recent Cochrane review; 7 yet, it might be beneficial in women with a gestational age of 41 weeks.…”

Section: Introductionmentioning

confidence: 99%

Membrane sweeping and prevention of post‐term pregnancy in low‐risk pregnancies: a randomised controlled trial

Miranda

Bom

Bonsel³

et al. 2006

BJOG

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Objective To evaluate the effectiveness of membrane sweeping at 41 weeks for the prevention of post-term pregnancy.Design A multicentre randomised controlled trial.Setting Fifty-one primary care midwifery practices in the Netherlands.Population A total of 742 low-risk pregnant women at 41 weeks of gestation.Methods Participants were randomly assigned to serial sweeping of the membranes (every 48 hours until labour commenced up to 42 weeks of gestation) or no intervention.Main outcome measures Post-term pregnancy ( ‡42 weeks). Subgroup analyses were performed on nulliparous and parous women. Secondary outcomes included adverse effects. NNT 6 [95% CI 4-6]). Adverse effects were similar in both the groups except for uncomplicated bleeding, which was reported more frequently in the sweeping group. Other obstetric outcomes and indicators of neonatal morbidity were similar in both groups. There were two perinatal deaths in each group.Conclusions Membrane sweeping at 41 weeks can substantially reduce the proportion of women with post-term pregnancy.

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“…No patients in either group had any unusual vaginal bleeding. A recent investigation 14 suggests that a combined therapy of membrane sweeping and dinoprostone is superior in preventing postterm pregnancies than either is alone.…”

Section: Commentmentioning

confidence: 99%

Membrane Sweeping versus Dinoprostone Vaginal Insert in the Management of Pregnancies beyond 41 Weeks with an Unfavorable Cervix

et al. 1999

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OBJECTIVE:To determine the best method of cervical ripening to prevent postdate inductions in women with an unfavorable cervix at 41 weeks' gestation. STUDY DESIGN:Women presenting at 41 weeks' gestation with a Bishop score of Յ4 received daily dinoprostone (Cervidil) vaginal inserts (group I) or daily membrane sweeping (group II). RESULTS:One-hundred and eighty-two women were prospectively randomized with 91 women in each arm. The women in group II, membrane sweeping, had Bishop scores significantly greater on admission for delivery (p Ͻ 0.001), had less time elapsed from admission to delivery (p ϭ 0.018), and had fewer labor inductions at 42 weeks (p ϭ 0.04) than the women in group I, the dinoprostone group. In addition, a greater number of women in group II were admitted in spontaneous labor (p ϭ 0.006) than in group I. Total antenatal costs for the membrane sweeping group was $15,120 versus $59,540 for the dinoprostone group. CONCLUSION:Daily membrane sweeping was more effective than dinoprostone administration with fewer postdate inductions at one-fourth the cost.Postterm pregnancy, with a reported frequency of 3% to 12%, 1 is a gestation extending beyond 42 weeks (294 days from the last menstrual period). These gestations may be complicated by oligohydramnios, meconium-stained amniotic fluid, macrosomia, fetal dysmaturity syndrome, and perinatal death.2,3 Of women presenting with a Bishop score of Յ4 at 41 weeks, 63% will remain undelivered at 42 weeks' gestation.

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Outpatient management of the uncomplicated postdate pregnancy with intravaginal prostaglandin E2 gel and membrane stripping

Cited by 4 publications

References 14 publications

Different methods for the induction of labour in outpatient settings

Different methods for the induction of labour in outpatient settings

Membrane sweeping and prevention of post‐term pregnancy in low‐risk pregnancies: a randomised controlled trial

Membrane Sweeping versus Dinoprostone Vaginal Insert in the Management of Pregnancies beyond 41 Weeks with an Unfavorable Cervix

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