Re: induction at 38 weeks

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Robin-

There are a number of important issues here. First, membrane stripping has been shown in a few small studies to be helpful for ripening (softening) the cervix, but it is not really used as an "induction" agent. There are very few contraindications to prostin gel cervical ripening. We don't use prior c/sections as a contraindication, but perhaps some places don't allow it to be used in women who have had a prior c/section. The main issue, however, is that there is no medical evidence that a baby a pound or two smaller makes labor any easier. I know that goes against common sense, but a number of good studies have shown that inducing labor to prevent a "big baby" may do more harm than good. *Every* pregnant patient thinks her baby is too big, whether she has had big babies before or not. And, most want an induction a few weeks early. Unfortunately, although most inductions are safe, they can cause excessive uterine stimulation, infection, increased bleeding, and, in some cases, they can fail, leading to another c/section.

Obviously there are a lot of factors at work with your OB history. Your doctor can examine your pelvis, check the baby, and come up with a game plan after discussing the options with you. I sincerely hope everything turns out great.

--
Ashley Hill
David Ashley Hill, M.D.
Associate Director
Department of Obstetrics and Gynecology
Florida Hospital Family Practice Residency
Orlando, FL
http://home.mpinet.net/dahmd

The above is intended for general medical education,
and is not for specific medical advice.
I apologize, but I am unable to answer personal e-mail
due to time constraints.

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