Introduction: The aim of this study was to compare vaginal dinoprostone and mechanical methods for induction of labor (IOL) in pregnancies complicated by late fetal growth restriction. Material and methods: Multicenter, retrospective, cohort study involving six referral centers in Italy and Spain. Inclusion criteria were pregnancies complicated by late fetal growth restriction as defined by Delphi consensus criteria. The primary outcome was the occurrence of uterine tachysystole; secondary outcomes were either cesarean delivery or operative vaginal delivery for non-reassuring fetal status, a composite score of adverse neonatal outcome and admission to neonatal intensive care unit (NICU). Univariate and multivariate logistic regression analysis was used to analyze the data. Results: A total of 571 pregnancies complicated by late fetal growth restriction undergoing IOL (391 with dinoprostone and 180 with mechanical methods) were included in the analysis. The incidence of uterine tachysystole (19.2% vs. 5.6%; p = 0.001) was higher in women undergoing IOL with dinoprostone than in those undergoing IOL with mechanical methods. Similarly, the incidence of cesarean delivery or operative delivery for non-reassuring fetal status (25.6% vs. 17.2%; p = 0.027), composite adverse neonatal outcome (26.1% vs. 16.7%; p = 0.013) and NICU admission (16.9% vs. 5.6%; p < 0.001) was higher in women undergoing IOL with dinoprostone than in those undergoing IOL with mechanical methods. At logistic regression analysis, IOL with mechanical methods was associated with a significantly lower risk of uterine tachysystole (odds ratio 0.26, 95% confidence interval 0.13-0.54; p < 0.001). Conclusions: In pregnancies complicated by late fetal growth restriction, IOL with mechanical methods is associated with a lower risk of uterine tachysystole, cesarean delivery or operative delivery for non-reassuring fetal status, and adverse neonatal outcome compared with pharmacological methods.

Maternal and neonatal outcomes of pregnancies complicated by late fetal growth restriction undergoing induction of labor with dinoprostone compared with cervical balloon: A retrospective, international study / Di Mascio, D.; Villalain, C.; Rizzo, G.; Morales-Rossello, J.; Sileo, F. G.; Maruotti, G. M.; Prefumo, F.; Galindo, A.; D'Antonio F, induction of labor in late fetal growth restriction COLLEGE study Group: Di Mascio D.; Villalain, C.; Buca, D.; Herraiz, I.; Rizzo, G.; Morales-Rossello, J.; Loscalzo, G.; Sileo, Fg.; Finarelli, A.; Bertucci, E.; Facchinetti, F.; Brunelli, R.; Giancotti, A.; Muzii, L.; Maruotti, Gm.; Carbone, L.; Saccone, G.; D'Amico, A.; Tinari, S.; Cerra, C.; Prefumo, F.; Nappi, L.; Greco, P.; Monaci, R.; Fichera, A.; Fratelli, N.; Liberati, M.; Galindo, A.; D'Antonio, F.. - In: ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA. - ISSN 0001-6349. - 100:7(2021), pp. 1313-1321-1321. [10.1111/aogs.14135]

Maternal and neonatal outcomes of pregnancies complicated by late fetal growth restriction undergoing induction of labor with dinoprostone compared with cervical balloon: A retrospective, international study

Sileo FG.;Finarelli A.;Bertucci E.;Facchinetti F.;
2021

Abstract

Introduction: The aim of this study was to compare vaginal dinoprostone and mechanical methods for induction of labor (IOL) in pregnancies complicated by late fetal growth restriction. Material and methods: Multicenter, retrospective, cohort study involving six referral centers in Italy and Spain. Inclusion criteria were pregnancies complicated by late fetal growth restriction as defined by Delphi consensus criteria. The primary outcome was the occurrence of uterine tachysystole; secondary outcomes were either cesarean delivery or operative vaginal delivery for non-reassuring fetal status, a composite score of adverse neonatal outcome and admission to neonatal intensive care unit (NICU). Univariate and multivariate logistic regression analysis was used to analyze the data. Results: A total of 571 pregnancies complicated by late fetal growth restriction undergoing IOL (391 with dinoprostone and 180 with mechanical methods) were included in the analysis. The incidence of uterine tachysystole (19.2% vs. 5.6%; p = 0.001) was higher in women undergoing IOL with dinoprostone than in those undergoing IOL with mechanical methods. Similarly, the incidence of cesarean delivery or operative delivery for non-reassuring fetal status (25.6% vs. 17.2%; p = 0.027), composite adverse neonatal outcome (26.1% vs. 16.7%; p = 0.013) and NICU admission (16.9% vs. 5.6%; p < 0.001) was higher in women undergoing IOL with dinoprostone than in those undergoing IOL with mechanical methods. At logistic regression analysis, IOL with mechanical methods was associated with a significantly lower risk of uterine tachysystole (odds ratio 0.26, 95% confidence interval 0.13-0.54; p < 0.001). Conclusions: In pregnancies complicated by late fetal growth restriction, IOL with mechanical methods is associated with a lower risk of uterine tachysystole, cesarean delivery or operative delivery for non-reassuring fetal status, and adverse neonatal outcome compared with pharmacological methods.
2021
1-mar-2021
100
7
1313-1321
1321
Maternal and neonatal outcomes of pregnancies complicated by late fetal growth restriction undergoing induction of labor with dinoprostone compared with cervical balloon: A retrospective, international study / Di Mascio, D.; Villalain, C.; Rizzo, G.; Morales-Rossello, J.; Sileo, F. G.; Maruotti, G. M.; Prefumo, F.; Galindo, A.; D'Antonio F, induction of labor in late fetal growth restriction COLLEGE study Group: Di Mascio D.; Villalain, C.; Buca, D.; Herraiz, I.; Rizzo, G.; Morales-Rossello, J.; Loscalzo, G.; Sileo, Fg.; Finarelli, A.; Bertucci, E.; Facchinetti, F.; Brunelli, R.; Giancotti, A.; Muzii, L.; Maruotti, Gm.; Carbone, L.; Saccone, G.; D'Amico, A.; Tinari, S.; Cerra, C.; Prefumo, F.; Nappi, L.; Greco, P.; Monaci, R.; Fichera, A.; Fratelli, N.; Liberati, M.; Galindo, A.; D'Antonio, F.. - In: ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA. - ISSN 0001-6349. - 100:7(2021), pp. 1313-1321-1321. [10.1111/aogs.14135]
Di Mascio, D.; Villalain, C.; Rizzo, G.; Morales-Rossello, J.; Sileo, F. G.; Maruotti, G. M.; Prefumo, F.; Galindo, A.; D'Antonio F, induction of labo...espandi
File in questo prodotto:
File Dimensione Formato  
aogs.14135 2021.pdf

Open access

Descrizione: articolo
Tipologia: Versione pubblicata dall'editore
Dimensione 360.55 kB
Formato Adobe PDF
360.55 kB Adobe PDF Visualizza/Apri
Pubblicazioni consigliate

Licenza Creative Commons
I metadati presenti in IRIS UNIMORE sono rilasciati con licenza Creative Commons CC0 1.0 Universal, mentre i file delle pubblicazioni sono rilasciati con licenza Attribuzione 4.0 Internazionale (CC BY 4.0), salvo diversa indicazione.
In caso di violazione di copyright, contattare Supporto Iris

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11380/1247936
Citazioni
  • ???jsp.display-item.citation.pmc??? 3
  • Scopus 14
  • ???jsp.display-item.citation.isi??? 14
social impact