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Obstetrics and Gynecology International
Volume 2013, Article ID 745159, 10 pages
Research Article

Cervical Ripening in The Netherlands: A Survey

1Department of Obstetrics and Gynecology, MC Haaglanden, 2512 VA The Hague, The Netherlands
2Department of Obstetrics, K6-P-35, Leiden University Medical Center, P.O. Box 9600, 2300 RC Leiden, The Netherlands
3Department of Obstetrics and Gynecology, Ikazia Hospital, 3008 AA Rotterdam, The Netherlands
4Department of Obstetrics and Gynecology, Amsterdam Medical Center, 1105 AZ Amsterdam, The Netherlands

Received 20 November 2012; Accepted 28 May 2013

Academic Editor: William A. Grobman

Copyright © 2013 Claartje M. A. Huisman et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objective. We aim to investigate methods and use of cervical ripening in women without and with a prior cesarean delivery in The Netherlands. Methods. In 2010, we conducted a postal survey in all Dutch hospitals with a labor ward. One gynecologist per hospital was addressed and was asked to respond on behalf of the staff. The questionnaire contained 31 questions concerning cervical ripening and induction of labor. We compared this survey to a similar Dutch survey conducted in 2006. Results. Response rate was 78% (70/92 hospitals). In women without a prior cesarean and in need of cervical ripening, all hospitals (100%) applied prostaglandins (either E1 or E2). In women with a prior cesarean, 21.4% of the hospitals performed an elective cesarean section if delivery was indicated (26.0% in 2006). In case of cervical ripening, 72.7% used mechanical methods (49.1% in 2006), 20.0% used prostaglandins (40.4% in 2006), 3.6% used a combination of prostaglandins and mechanical methods, and 3.6% used membrane-sweeping or oxytocin. Conclusions. In 2010, in The Netherlands, prostaglandins and Foley catheters were the preferred methods for cervical ripening in women without and with a prior cesarean, respectively. Use of mechanical methods in women with a prior cesarean has increased rapidly between 2006 and 2010, corresponding with decreasing use of prostaglandins and elective repeat cesarean sections.