Abstract
I was surprised that Mr. Philip M. Tromans and others (February 28 p. 679) neglected to discuss the relatively high cesarean section rates (23% and 27%) in the groups of patients they studied. Recently at St. Marys Hospital Manchester the effects of a (PG) prostaglandin vaginal pessary (3 mg PGE2 in a Witepsol base) or an intracervical extraamniotic Foleys catheter on cervical ripening prior to induction were studied prospectively in 66 patients. Although both methods significantly improved the modified Bishop score and decreased the length of subsequent labor compared with the controls the cesarean section rates were similar in all groups (PGE2 group--27%; Foleys catheter group--32%; control group--27%). In our study 68% of patients delivered by cesarean section had cephalopelvic disproportion. The possibility of cephalopelvic disproportion should therefore be considered in women admitted for induction of labor with an unripe cervix. (Full Text)
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