Pre-induction cervical ripening: Comparing between two vaginal preparations of dinoprostone in women with an unfavorable cervix

Eran Ashwal, Liran Hiersch, Nir Melamed, Yaara Manor, Arnon Wiznitzer, Moshe Hod, Yariv Yogev

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: Prostaglandin E2 (PGE2-Dinoprostone) is accepted for both ripening of the cervix and induction of labor. As conflicting data exist concerning the efficiency and safety of different treatment modalities, we aimed to compare slow-release vaginal insert PGE2 with serial vaginal tablets of PGE2 for cervical ripening and induction of labor. Methods: A retrospective cohort study comparing all pregnancies who underwent induction of labor by either a single slow-release vaginal insert of 10mg PGE2 (study group) to a historical control group of women who were treated with serial administration of 3mg vaginal PGE2 tablets in a 2:1 ratio, matched by parity. Results: Overall, 639 women were enrolled (213 treated with PGE2 tablets and 426 with slow-release vaginal inserts). Vaginal insert was associated with shorter initiation-to-ripening interval (12.4±7.7 versus 18.6±15.2h, p<0.001) and a higher rate of delivery within 24h (61.5 versus 51.6%, p=0.018). Vaginal insert was associated with an increased rate of tachysystole (8.0 versus 3.1%, p<0.01); however, the rates of cesarean section or operative delivery due to non-reassuring fetal heart rate (NRFHR) were similar. On multivariable analysis, slow-release vaginal insert was independently associated with a higher rate of delivery within 24h (OR 1.50, 95% CI 1.04-2.18). Conclusion: Slow-release PGE2 vaginal insert achieves cervical ripening and subsequently delivery over a shorter time period than PGE2 tablets, without increasing uterine hyperstimulation rate.

Original languageEnglish
Pages (from-to)1874-1879
Number of pages6
JournalJournal of Maternal-Fetal and Neonatal Medicine
Volume27
Issue number18
DOIs
StatePublished - 1 Dec 2014

Keywords

  • Cervical ripening
  • Dinoprostone
  • Induction of labor
  • Vaginal insert

Fingerprint

Dive into the research topics of 'Pre-induction cervical ripening: Comparing between two vaginal preparations of dinoprostone in women with an unfavorable cervix'. Together they form a unique fingerprint.

Cite this