The use of extraamniotic dexamethasone for ripening the unfavourable cervix

الملخص EN

Objective : study the effect of topical corticosteroids on ripening of the cervix and initiation of labor process.

Setting:’ Labor room’ in Basra Maternity (teaching) Hospital with 300 bed capacity.

Design : A prospective comparative study was conducted to compare two methods of ripening the unfavourable cervix.

Method I (group I) : - ripen the cervix using Foley’s catheter with extra amniotic normal saline instillation.

Method II (group II) :- Ripen the cervix using Foley’s catheter with extra amniotic normal saline and 20 mg of dexamethasone to be injected extraamnioticaly by a catheter before normal saline instillation.

Results :- the clinical trial involved a total of 127 pregnant women, of those (65) patients were included in method I, and 62 patients were included in method II, the success rate in achieving cervical ripening was 100 % for both methods.

The mean ripening times in method II (primigravidae (5.43 ± 1.06), multipara (5.10 ± 0.6)) were significantly shorter than those in method primigravidae (7.54 ± 1.02), multipara(6.33) ± 1.2)), the induction delivery times were significantly shorter in method II primigravidae (7.0 ±1.21), multipara (5.54 ± 2.02) than those in method I primigravidae (7.9 ± 2.01) multipara (6.19 ± 1.96).

Most of women under study have spontaneous vaginal delivery, method (I) 55 (84.6 %) and method II 54 (87 %).

Conclusion :- induction of labor using extra amniotic Foley’s catheter and dexamethasone reduces the ripening and induction delivery times, this may indicate a possible role for corticosteroids in the parturition process.