Urgency of the problem prolonged pregnancy is explained by large number of complications in childbirth, a significant incidence of operative delivery and a high rate of prenatal morbidity and mortality. Childbirths women at terms of full-term pregnancy allows preventing birth a child of post-term and reduce the risk of prenatal complications and late effects. Willingness of pregnant women for childbirth, the state of the cervix largely determine the current and an outcome birth. The absence of mature cervix at 40-41 weeks of gestation is the basis for appropriate assessment of the situation and obstetric active tactics aimed at preparing maternal passages. The trend is to a departure from the "aggressive" Obstetrics priority belongs finding ways of minimally invasive cervical ripening. The experience of the last decade shows that the rejection of the scheme adopted "programmed births", consisting in the of amniotomy and labor induction, is justified, since this tactic is fraught with a high frequency of abnormalities of labor, fetal distress and surgical delivery. Timely and adequate preparation for childbirth pregnancy, induction of maturity of the cervix allows counting on independent onset of birth hand considerably to lower obstetric traumatism. Its modern facilities, is used to prepare the cervix for childbirth relate, prostaglandin E2, Laminaria and progesterone antagonists. However, this diverse group of tools having their contra restrictions in application and probably different efficiencies. Based on the above mentioned data we have set ourselves. Objective: To evaluate the effectiveness of methods delivery and develop recommendations for their intended purpose differentiated in various conditions.

Materials and methods.

Under observation are 150 women with term pregnancy. Supervision is 150 women with term pregnancy. We used the following inclusion criteria: gestational age from 41 to 43 weeks, cephalic presentation of the fetus, and the state of the cervix from 0 to 4 points on the index Bishop, the lack of evidence for an emergency delivery. Depending on the method of preparation of the cervix women were divided into three groups. Group 1 consisted of 63 women with cervical preparation have started with the appointment of the drug antiprogesten  effects of mifepristone (Company "Mir-farm", Russia). Drug is took the scheme: 200 mg (1 tablet) once daily orally for two days with an interval of 24 hours. In Group 2 comprised 43 women who were administered intracervically Glandin E2 (dinoprostone), in the third - 44 women who had used sticks kelp introduced into the cervical canal. Before preparation for childbirth pregnant the following examinations were carried out: Ultrasound (fetometriya and Doppler), cytology smear. The clinical efficacy of various means was evaluated using the following criteria: frequency of spontaneous labor, the frequency and nature of complications in childbirth, caesarean section rates, and the state of the newborn. Self onset of labor in group 1 was noted in 55 (87.3%) pregnant women in the 2nd - in 41 (83.7%), and the third - in 37 (84.09%). Of labor induction was conducted in group 1 in 5 in the 2nd - in 2, in the third - in 2 patients. Greatest frequency of anomalies of labor was observed in 2 patients and third groups. Pathological preliminary period, discoordination or weakness of labor occurred in 18 (41.8%) of women who received dinoprostone, and 25 (56.8%) - sticks laminaria. In group 1 childbirth complications occurred in 19 (26.9%) women. Prevailing weakness of labor (at 15), the therapy which in most cases (11) was successful and resulted in birth naturally, which is consistent with the known characteristics of the drug mifepristone antigestagens as a means of improving the sensitivity of the myometrium to the action and effectiveness of uterotonic therapy of contractile activity uterus. High frequency of pathological preliminary period and diskoordinatsion labor was observed in group 2. The results of other authors also point to the early appearance of uterine activity (up to cervical ripening), and hyper-local application dinoprostone [1, 2]. Fetal hypoxia was observed in group 2, 1.4, and in the third - 1.9 times more than in the 1st. As a rule, it was combined with abnormalities of labor. In group 1 in 51 (79.7%) women completed birth vaginally, in 12 (20.3%) - by Caesarean section, in group 2 -, respectively, in 29 (67.5%) and 14 (32.5%), in the 3rd - 29 (66%) and 19 (34%). The high frequency of abdominal delivery of patients treated with dinoprostone and sticks laminaria, due to a significant number of complications in these groups. The main indications for cesarean section were fetal hypoxia, abnormal labor, and obstructed and premature detachment of placenta. In 3 pregnant women in Group 1 with high prenatal risk cesarean section was performed because of the inefficiency of labor induction.

Prenatal outcomes of labor are shown in Table. 1.

The condition of children at birth in the examined groups Apgar

A comparison of the effectiveness of three methods of cervical preparation for childbirth by clarifying the treatment regimen: what and under what conditions should be prescribed. With the trend towards postmaturity optimal use of anti-progestins, or prostaglandin E2. Dinoproston most effective in rebirth. The lowest frequency of complications of labor and cesarean section was observed with the use of mifepristone. With the introduction of laminaria sticks noted the high frequency of anomalies of uterine activity and caesarean section. Essential disadvantages application as laminaria and dinoprostone are significant frequency of pathological preliminary period and the beginning of unproductive labor in an immature or mature insufficiently cervix. The introduction of cervical dinoprostone and sticks laminaria - invasive medical intervention, conjugate with a significant inconvenience for the patient. Mifepristone is appointed inside, and two-time taking it easy and do not allow to realize the side effects inherent to antigestagens after long term use.

Thus, the study of the outcome of the pregnancy and delivery, depending on the method of induction of labor mifepristone confirmed such advantages as a non-invasive method of administration, the possibility of applying for an immature cervix and its role in the ripening of the cervix for childbirth preparation of the myometrium to the subsequent use of uterotonic and efficiency genus stimulation.

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4. Novitsky I.S., Belomestnova L.N., Black A.P. The effect of pregnancy on the condition postmaturity placenta and fetus / / Obstetrics and Gynecology. - 2006.

5. Podtetenev A.D., Bratchikova T.V., Kokshtayn G.A. regulation of labor. - M., 2004. - 54.

6. Alehander J.M.,Mc Intire D.D., Leveno K.J. Prolong pregnancy; induction of labour and cesarean births // Obstet. Gynecol.- 2001.-Vol.97.- 911p.

7. American College of Obstetricians and Gynecologists: Management of post-term pregnancy// Practice Bulletin. - №55. - September. - 2004.