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    Am Fam Physician. 2003 May 15;67(10):2123-8.

    Methods for cervical ripening and induction of labor.

    Tenore JL.

    Department of Family Medicine, Northwestern University Medical School, Chicago, Illinois 60611, USA. josietenore@hotmail.com

    Comment in:

    Induction of labor is common in obstetric practice. According to the most current studies, the rate varies from 9.5 to 33.7 percent of all pregnancies annually. In the absence of a ripe or favorable cervix, a successful vaginal birth is less likely. Therefore, cervical ripening or preparedness for induction should be assessed before a regimen is selected. Assessment is accomplished by calculating a Bishop score. When the Bishop score is less than 6, it is recommended that a cervical ripening agent be used before labor induction. Nonpharmacologic approaches to cervical ripening and labor induction have included herbal compounds, castor oil, hot baths, enemas, sexual intercourse, breast stimulation, acupuncture, acupressure, transcutaneous nerve stimulation, and mechanical and surgical modalities. Of these nonpharmacologic methods, only the mechanical and surgical methods have proven efficacy for cervical ripening or induction of labor. Pharmacologic agents available for cervical ripening and labor induction include prostaglandins, misoprostol, mifepristone, and relaxin. When the Bishop score is favorable, the preferred pharmacologic agent is oxytocin.

    PMID: 12776961 [PubMed - indexed for MEDLINE]

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    Patient drug information

    • Dinoprostone (Cervidil®, Prepidil®, Prostin E2®)

      Dinoprostone is used to prepare the cervix for the induction of labor in pregnant women who are at or near term. This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

    • Mifepristone (Mifeprex®)

      Mifepristone is used alone or in combination with misoprostol (Cytotec) to end an early pregnancy. Early pregnancy means it has been 49 days or less since your last menstrual period began. Mifepristone is in a class of m...

    • Misoprostol (Cytotec®)

      Misoprostol is used to prevent ulcers in people who take certain arthritis or pain medicines, including aspirin, that can cause ulcers. It protects the stomach lining and decreases stomach acid secretion.