The Cervix
Oct. 9th, 2021 06:24 am![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
whitewriter of nulliparous women at term, undergoing elective induction compared with expectant management -
in nulliparous women:
cesarean delivery rate was 20.8% among those with a favourable cervix and
43.1% among those with an unfavourable cervix
The bishop score was created using multiparous women. In fact, it was used to predict success for elective inductions in multiparous women at term.
However -- most IOL done today are in nulliparous women. 25% of pregnant women in the USA underwent an IOL in 2015.
It goes on to say that cervical status in gravid patients with a history of vaginal delivery is so successful that cervical status is not particularly useful for determining candidacy in these women (!!??!!)
In the 1930s they tried to bring in rectal examinations because - it didn't require hand washing or gloves (yuck!)- caused less infection (...) from less direct contact with the cervix. However it was inaccurate, and not acceptable to most women (thank God) so they stopped doing it.
The article goes on to talk about other historical methods of assessing cervical dilation including mechanical and electromagnetic devices, which were found not to be any more accurate than the humble VE - (and less acceptable) and so were abandoned by the 1980s.
Reference needed... I'll get it in a tick... and what does it mean for clinical practice.
in nulliparous women:
cesarean delivery rate was 20.8% among those with a favourable cervix and
43.1% among those with an unfavourable cervix
The bishop score was created using multiparous women. In fact, it was used to predict success for elective inductions in multiparous women at term.
However -- most IOL done today are in nulliparous women. 25% of pregnant women in the USA underwent an IOL in 2015.
It goes on to say that cervical status in gravid patients with a history of vaginal delivery is so successful that cervical status is not particularly useful for determining candidacy in these women (!!??!!)
In the 1930s they tried to bring in rectal examinations because - it didn't require hand washing or gloves (yuck!)- caused less infection (...) from less direct contact with the cervix. However it was inaccurate, and not acceptable to most women (thank God) so they stopped doing it.
The article goes on to talk about other historical methods of assessing cervical dilation including mechanical and electromagnetic devices, which were found not to be any more accurate than the humble VE - (and less acceptable) and so were abandoned by the 1980s.
Reference needed... I'll get it in a tick... and what does it mean for clinical practice.
