Comparison of Safety and Efficacy of Two Different Protocols of Cervical Ripening and Induction of Labor

Induction of labor is the intentional initiation of labor before spontaneous onset, for the purpose of delivery of feto-placental unit. Cervical ripening is a prelude to the onset of labor whereby the cervix becomes soft and compliant. It has been recognized that components of labor i.e. cervical and uterine changes, involve prostaglandins, inflammatory mediators and other agents. Most methods of induction seek to exploit these components in order to initiate labor. The goal of cervical ripening is to facilitate the process of cervical softening, thinning, and dilating with resultant reduction in the rate of failed induction and induction to delivery time. When induction of labor is decided, the goal is to achieve a vaginal delivery within a reasonable period of time, minimising the side-effects for both the mother and the newborn. The side effects include dysfunctional labor and excessive uterine activity, eventually with fetal distress leading to increased caesarean section rate. Induction with oxytocin with or without artificial rupture of membranes is associated with a high failure rate when the cervix is unripe.