Original article

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

¹Department of Obstetrics and Gynecology, Naval Medical Center-San Diego (M. F. M., C. M. E.);

²University of Mississippi Medical Center (E. F. M., J. D. B., J. C. M.), Jackson, Mississippi;

³Medical College of Georgia (S. P. C.), Augusta, GA.

Correspondence to: Everett F. Magann MD, University ofMississippi Medical Center, Department of Obstetrics and Gynecology,2500 North State Street, Jackson, MS 39216-4505.

^†Presented at the 18th Annual Meeting of the Society of PerinatalObstetricians, Miami Beach, FL, February 1998.

Abstract

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 £4 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 < 0.001), had less time elapsed from admission to delivery (p = 0.018), and had fewer labor inductions at 42 weeks (p = 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 = 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.

March 1999, Volume 19, Number 2, Pages 88-91

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