The aim of this study was to compare the clinical effects of preinduction cervical ripening by using two ways of dinoprostone administration. In a prospective, open-label trial, 144 consecutive nulliparous women with a Bishop score < 4 who required induction of labour at term were randomised to receive dinoprostone via either a vaginal insert (10 mg over 12 h)or a cervical gel(0.5 mg, twice in 12h). If labour did not start by 24 h after this preinduction, patients received 2 mg vaginal dinoprostone gel followed 6 h later by oxytocin infusion. The main outcome measure was the rate of caesarean sections (CS). Secondary measures were: changes in Bishop score at 6 h and 12 h, delivery within 12 h and 24 h, need for oxytocin for induction, failure of induction (delivery after > 48 h), need for pharmacological interventions to manage tachysystole/hyperstimulation, length of stay in hospital. The CS rate was lower in the vaginal insert group (22.9%) than in the cervical gel group (34.3%), though the difference did not reach statistical significant difference (P = 0.13). The indications for CS overlapped between the groups. The rate of vaginal delivery within 12 It and 24 h was similar, as was the rate of failure of induction. More women in the gel group (41.4% versus 24.3%) required the use of oxytocin (OR = 2.21: 95% CI = 1.07-4.55). Tachysystole or hyperstimulation in the vaginal insert group (7) was twice that with cervical gel (4). Four women in the vaginal insert group and three in the cervical gel group reported infectious complications. A long stay in hospital (> 4 days) was less frequent with vaginal inserts (21.4 versus 38.6%; OR = 0.43, 95% CI = 0. 19-0.97). The more challenging preinductions of labour at term are associated with increased obstetric interventions such as a high CS rate and a more frequent requirement for oxytocin inductions. In terms of success and failure, vaginal inserts releasing dinoprostone do not differ from dinoprostone given by the traditional cervical route. However, the use of vaginal inserts reduces the need for obstetric interventions and allows shorter periods in hospital.

Comparison of two preparations of dinoprostone for pre-induction of labour in iparous women with very unfavourable cervical condition: a randomised clinical trial / Facchinetti, Fabio; P., Venturini; G., Verocchi; Volpe, Annibale. - In: EUROPEAN JOURNAL OF OBSTETRICS, GYNECOLOGY, AND REPRODUCTIVE BIOLOGY. - ISSN 0301-2115. - STAMPA. - 119:2(2005), pp. 189-193. [10.1016/j.ejogrb.2004.06.039]

Comparison of two preparations of dinoprostone for pre-induction of labour in iparous women with very unfavourable cervical condition: a randomised clinical trial

FACCHINETTI, Fabio;VOLPE, Annibale
2005

Abstract

The aim of this study was to compare the clinical effects of preinduction cervical ripening by using two ways of dinoprostone administration. In a prospective, open-label trial, 144 consecutive nulliparous women with a Bishop score < 4 who required induction of labour at term were randomised to receive dinoprostone via either a vaginal insert (10 mg over 12 h)or a cervical gel(0.5 mg, twice in 12h). If labour did not start by 24 h after this preinduction, patients received 2 mg vaginal dinoprostone gel followed 6 h later by oxytocin infusion. The main outcome measure was the rate of caesarean sections (CS). Secondary measures were: changes in Bishop score at 6 h and 12 h, delivery within 12 h and 24 h, need for oxytocin for induction, failure of induction (delivery after > 48 h), need for pharmacological interventions to manage tachysystole/hyperstimulation, length of stay in hospital. The CS rate was lower in the vaginal insert group (22.9%) than in the cervical gel group (34.3%), though the difference did not reach statistical significant difference (P = 0.13). The indications for CS overlapped between the groups. The rate of vaginal delivery within 12 It and 24 h was similar, as was the rate of failure of induction. More women in the gel group (41.4% versus 24.3%) required the use of oxytocin (OR = 2.21: 95% CI = 1.07-4.55). Tachysystole or hyperstimulation in the vaginal insert group (7) was twice that with cervical gel (4). Four women in the vaginal insert group and three in the cervical gel group reported infectious complications. A long stay in hospital (> 4 days) was less frequent with vaginal inserts (21.4 versus 38.6%; OR = 0.43, 95% CI = 0. 19-0.97). The more challenging preinductions of labour at term are associated with increased obstetric interventions such as a high CS rate and a more frequent requirement for oxytocin inductions. In terms of success and failure, vaginal inserts releasing dinoprostone do not differ from dinoprostone given by the traditional cervical route. However, the use of vaginal inserts reduces the need for obstetric interventions and allows shorter periods in hospital.
2005
119
2
189
193
Comparison of two preparations of dinoprostone for pre-induction of labour in iparous women with very unfavourable cervical condition: a randomised clinical trial / Facchinetti, Fabio; P., Venturini; G., Verocchi; Volpe, Annibale. - In: EUROPEAN JOURNAL OF OBSTETRICS, GYNECOLOGY, AND REPRODUCTIVE BIOLOGY. - ISSN 0301-2115. - STAMPA. - 119:2(2005), pp. 189-193. [10.1016/j.ejogrb.2004.06.039]
Facchinetti, Fabio; P., Venturini; G., Verocchi; Volpe, Annibale
File in questo prodotto:
File Dimensione Formato  
comparison of two preparations.pdf

Solo gestori archivio

Tipologia: Versione pubblicata dall'editore
Dimensione 87.69 kB
Formato Adobe PDF
87.69 kB Adobe PDF   Visualizza/Apri   Richiedi una copia
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/11380/308044
Citazioni
  • ???jsp.display-item.citation.pmc??? 1
  • Scopus 24
  • ???jsp.display-item.citation.isi??? 19
social impact