Management of post-date pregnancies with unfavorable cervix in primigravida

Abstract EN

Objective: To determine the best management of pregnancy beyond 41 weeks, with an unfavorable cervix for induction in primigravida. Method: Two hundred and six pregnant women with uncomplicated pregnancies that reached 41 week gestation with unfavorable cervix (Bishop Score< 4); cephalic presentation were randomly allocated into two groups.

First group, the study group: daily placement of prostaglandin pessary until 42 weeks.

While in the second group daily cervical examination and assessment.

Study and control group ratio was 1:1.

The date confirmed by ultrasound early booking. Results: In the study group, ninety-three of patients (90.3%) had successful outcome after one or two prostaglandin pessaries.

Ten of patients ( 9.7%) reached 42 weeks of gestation without any cervical changes. In the control group, seventy three of patients (70.9%) reached 42 weeks of gestation without any cervical changes (the same Bishop Score), while thirty of patients (29.1%) had spontaneous labor. Conclusion: Daily placement of a prostaglandin pessary is successful in reducing the number of inductions of labor at 42 weeks for post-term pregnancies.