Stripping of fetal membranes involves bluntly separating the Once amniotomy is performed, the patient is committed to delivery. Induction of labor in a woman with a favorable cervix by amniotomy or a combination of amniotomy and oxytocin is widely accepted and used. Many obstetricians will perform amniotomy only after regular contractions are established and in the setting The state of the cervix is related to the success of labor induction. A cervical scoring system designed by Bishop has been used by many to predict inducibility, with a score of 4 or less considered unfavorable. Prostaglandin E2 can be given intravaginally as suppositories or a gel.
Side effects are few and include fever, vomiting, and diarrhea.
There is a risk of uterine rupture when prostaglandins are used after 28 weeks of gestation. Prostaglandin is the preferred agent for preinduction cervical ripening. Prostaglandin given for cervical ripening reduces the rates of failed induction, cesarean birth, and instrumental vaginal delivery, a single intracervical Commercially available preparations are PGE2 gel preparations in doses of 0.5 mg and PGE2 vaginal suppositories. The gel preparations and the vaginal suppositories are used in clinical practice to ripen the cervix. Both intracervical and intravaginal instillations of PGE2 have been used to ripen the cervix.