Razi Journal of Medical Sciences

    Background & Aim: Pregnancy termination in cases with unripe cervix is a problem for obstetricians and finding a way to ripen the cervix in order to get a better response to the induction of labor is ideal. The aim of the present study is to make a comparison between extra-amniotic normal saline solution infusion per se and combined with dexamethasone for cervical ripening and labor induction. Patients & Method: A double-blind randomized clinical trial was performed in Akbarabadi Hospital in Tehran between March 2002 and 2003. The subjects were 84 pregnant women with gestational age of 40 weeks or more, Bishop score≤5, single cephalic presentation, and intact membrane who had been admitted for termination of pregnancy. They were randomly assigned to two groups. 41 cases received dexamethasone(20 mg) plus extra-amniotic saline solution infusion(EASI) and for 43 patients EASI alone was prescribed. 6 hours after EASI, labor induction was started by oxytocin. Then the progress of labor was followed and compared in both groups. Results: There was no statistically significant difference between the groups according to age, parity, gravidity, and primary Bishop score. From 84 patients, 75 cases entered the active phase of labor. They included 38 patients(88.37%) in EASI group and 37 patients(90.25%) in combined group but the difference was not significant. The duration between oxytocin infusion and delivery time was 7.25±2.86 hours and 9.76±3.91 hours in combined and EASI groups respectively, which showed a statistically significant difference(P=0.002). There was also no significant difference between the two groups according to cesarean section rate, meconium passage by fetus, neonatal Apgar score, birth weight, and need for NICU(Neonatal Intensive Care Unit). However, there was a statistically significant negative relation between gravidity and the interval between oxytocin induction and delivery(P=0.001, r=-0.474). Conclusion: Extra-amniotic saline solution infusion is a suitable and inexpensive method for cervical ripening and labor induction and adding dexamethasone to it can shorten the duration of labor without any significant risk for mother or her fetus.