Preinduction cervical ripening with prostaglandin E2 at preterm

Nir Melamed, Yariv Yogev, Eran Hadar, Moshe Hod, Avi Ben-Haroush

Research output: Contribution to journalArticlepeer-review

Abstract

Objective. To evaluate the efficacy of prostaglandin E2 (PGE2) for cervical ripening at preterm and to identify factors predicting ripening failure. Design. A retrospective study of women admitted for preinduction cervical ripening with PGE2 vaginal tablets at preterm (n=444). PGE2 vaginal tablets were administered at 6-8 h intervals until cervical ripening was achieved (Bishop score ≥7) or ripening failed (Bishop score <7 after administration of 4 PGE2 tablets). Data were compared with a control group of women admitted for preinduction cervical ripening with PGE2 vaginal tablets at term (n=1,029). A multivariate logistic regression analysis was performed to detect factors predicting ripening failure. Results. Women at preterm required a significantly higher number of PGE2 tablets compared to women at term (2.0±1.1 versus 1.6±0.9, p<0.001). Overall rates of ripening failure and caesarean section due to failed induction were significantly higher in preterm than term gestations (11.4 versus 1.1% and 9.7 versus 0.4%, p<0.001), and were inversely related to gestational age. Nulliparity, lower gestational age at delivery, lack of cervical dilatation, and higher maternal age were significant predictors of ripening failure at preterm. Conclusion. The use of PGE2 for preinduction cervical ripening at preterm may be associated with an increased risk of ripening failure and caesarean section compared with term gestations. This information may be useful when consulting women regarding the available options when premature delivery is necessary.

Original languageEnglish
Pages (from-to)63-67
Number of pages5
JournalActa Obstetricia et Gynecologica Scandinavica
Volume87
Issue number1
DOIs
StatePublished - 2008

Keywords

  • Induction
  • PGE
  • Preterm
  • Prostaglandin
  • Ripening

Fingerprint

Dive into the research topics of 'Preinduction cervical ripening with prostaglandin E2 at preterm'. Together they form a unique fingerprint.

Cite this