[Management of pregnancies beyond forty-one week's gestation with an unfavorable cervix]

Abstract

Objective: Our purpose was to determine the optimal management of pregnancies beyond 41 week's gestation with a cervix unfavorable for induction.

Material and method: All uncomplicated pregnancies that reached 41 weeks'gestation with a Bishop score of< or =4, were randomly assigned to one of two groups

Results: The duration of labor was shorter in the group "prépidil" compared with the control group (P=0.002). Identification of an unfavorable cervix at 41 weeks was unlikely to change by 42 weeks and cervical ripening was required in 40% cases. There was no significant difference in caesarean section rates. Rates of admission into the neonatal unit and fetal outcomes were similar in the two groups.

Conclusion: Cervical ripening with prostaglandin gel at 41 week's gestation for uncomplicated singleton pregnancies is safe and should be advocated.