Mechanical methods

1. Membrane stripping is a widely utilized technique, which causes release of either prostaglandin F2-alpha from the decidua and adjacent membranes or prostaglandin E2 from the cervix.

Weekly membrane stripping beginning at 38 weeks of gestation results in delivery within a shorter period of time (8.6 versus 15 days).

2. Amniotomy is an effective method of labor induction when performed in women with partially dilated and effaced cervices. Caution should be exercised to ensure that the fetal vertex is wellapplied to the cervix and the umbilical cord or other fetal part is not presenting.

3. Foley catheter. An uninflated Foley catheter can be passed through an undilated cervix and then inflated. This technique is as effective as prostaglandin E2 gel. The use of extra-amniotic saline infusion with a balloon catheter or a double balloon catheter (Atad ripener) also appears to be effective for cervical ripening.

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