![]() ![]() Note: The placental disorders placenta previa, vasa previa, and invasive placental disorders were removed from this table because all typically require cesarean delivery. Twin gestation, monochorionic or other condition HIV infection (if viral load ≤ 1,000 copies per mL) Randomized controlled trials and systematic reviewĬonsider combining a balloon catheter and misoprostol for cervical ripening to shorten time to delivery. Lower-quality or inconsistent evidence, with no benefit in one trial of parous women but shorter time to delivery in another trial of only nulliparous womenĬonsider using vaginal misoprostol (Cytotec) for cervical ripening to increase the likelihood of vaginal delivery within 24 hours. 32Ĭonsider outpatient placement of a Foley catheter for cervical ripening in nulliparous patients with an unfavorable cervix (full Bishop score of less than 6). Membrane sweeping in the outpatient setting can increase the likelihood of spontaneous labor within 48 hours. If your cervix is still completely closed the doctor can’t do a membrane sweep as they cannot get their fingers up far enough. Regular, moderate exercise and breast massage both increase the likelihood of spontaneous labor. What is a membrane sweep A membrane sweep is often done in conjunction with a cervical check to see if you are dilated or effaced. Practice guideline prospective and retrospective cohort studies 5, 6Ĭonsistent evidence of improved patient outcomes in a large cohort study practice guidelineĪvoid prostaglandins in patients with prior cesarean delivery or major uterine surgery because of the increased risk of uterine rupture. Avoid induction of labor before 39 weeks' gestation if there is no medical indication. ![]()
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