Combined method of preparing the cervix uteri for labor in pregnant women with a lack of birth preparedness and a tendency to post-term pregnancy

Objective. Development of an effective method for preparing the cervix in pregnant women with a tendency to overmaturity against the background of a lack of biological readiness for childbirth, as well as reducing the time for preparing the soft birth canal for childbirth in order to conduct subsequent labor excitation.

Material and methods. The patients were divided into 3 groups depending on the method of preparing the cervix for childbirth: in the 1st group (n = 50) only laminaria was used; in group 2 (n = 50), a Foley catheter was used in combination with mifepristone; in group 3 (n = 50), only mifepristone was used. Inclusion criteria: gestational period 41 weeks – 41 weeks and 4 days inclusive, immature cervix (baseline score on the Bishop scale 0-2 points), singleton pregnancy, cephalic presentation, whole fetal bladder, vaginal cleanliness I-II, satisfactory fetal condition (normal type of curve according to CTG and the absence of fetal hemodynamic disorders according to Doppler data). Statistical processing of the obtained data was carried out using the STATISTICA 10.0 program.

Research results. The patients of the three groups were comparable in age, gestational age, and did not differ in the parity of childbirth and body mass index. With the combined preparation of the cervix for childbirth with mifepristone and a Foley catheter, the dynamics of the assessment of the cervix on the Bishop scale is higher and achieved faster than when preparing for childbirth only with laminaria or only antigestagens. When combining mifepristone with a catheter Foley, it is possible to reduce the time interval from the onset of pre-induction to the development of labor in comparison with pre-induction of labor only with mifepristone or only with the help of laminaria, as well as reduce the frequency of caesarean section due to the lack of effect from induction of labor compared with pre-induction of labor only with mifepristone or only with the help of laminaria. The undoubted advantage of this combined method of preparing the cervix for childbirth is its effectiveness, low risk of uterine hyperstimulation, fetal distress syndrome, as well as the absence of a high risk of developing infectious complications.

Conclusion. The combined method of preparing the body for childbirth with a tendency to post-term pregnancy is effective, safe and allows you to reduce the preparation time of the soft birth canal for childbirth against the background of a lack of biological readiness for childbirth with a tendency to post-term pregnancy.