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Clinical and Experimental Obstetrics & Gynecology  2020, Vol. 47 Issue (5): 664-668    DOI: 10.31083/j.ceog.2020.05.5426
Original Research Previous articles | Next articles
The role of dinoprostone for labor induction in postterm and high-risk term pregnancies
I.F. Urunsak1, U.K. Gulec1, *(), E. Eser2, M. Sucu1, C. Akcabay1, S. Buyukkurt1
1Cukurova University, Faculty of Medicine, Department of Obstetrics and Gynecology, Turkey
2Niğde Ömer Halisdemir University, Faculty of Medicine, Department of Obstetrics and Gynecology, Turkey
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Abstract  

Purpose: To determine the effect of controlled release vaginal dinoprostone (CRVD) in post-term and high-risk term pregnancies on successful ripening, the length of active labour, the total time for delivery, route of delivery, and maternal-neonatal outcomes. Methods: We performed a retrospective study on women undergoing cervical ripening with CRVD. A total of 94 post-term pregnancies (group 1) were compared with 138 high-risk pregnancies requiring labour induction due to maternal and/or fetal indications at term (group 2). The primary outcome of the study was vaginal delivery within 24 hours. Length of active labour, the total time for delivery, route of delivery and maternal and neonatal outcomes were evaluated as secondary outcomes. Results: Vaginal delivery rates were 73.4% (69/94) and 81.9% (113/138) in groups 1 and 2, respectively (p = 0.123). The mean delivery lengths were 16.6 ± 9.5 and 16 ± 8.9 hours in groups 1 and 2, respectively (p = 0.259). Both groups were also similar regarding the length of active labour (9.3 ± 6.7 and 9.6 ± 6.8 hours; p = 0.717). Cesarean section rates were 23.4% and 13% in groups 1 and 2, respectively (p = 0.04). There were no differences in maternal and neonatal outcomes between the groups. Conclusion: Our study showed that dinoprostone is effective for labour induction, particularly in high-risk term pregnancies.

Key words:  Dinoprostone      High-risk pregnancy      Induction of labour      Oxytocin      Post-term pregnancy     
Submitted:  15 November 2019      Accepted:  06 March 2020      Published:  15 October 2020     
*Corresponding Author(s):  U.K. Gulec     E-mail:  ukucukgoz@yahoo.com

Cite this article: 

I.F. Urunsak, U.K. Gulec, E. Eser, M. Sucu, C. Akcabay, S. Buyukkurt. The role of dinoprostone for labor induction in postterm and high-risk term pregnancies. Clinical and Experimental Obstetrics & Gynecology, 2020, 47(5): 664-668.

URL: 

https://ceog.imrpress.com/EN/10.31083/j.ceog.2020.05.5426     OR     https://ceog.imrpress.com/EN/Y2020/V47/I5/664

Table 1  — General and obstetric characteristics of the population.
Groups
Mean ± SD
Median (min-max)
Subgroups of group 2
Mean ± SD
Median (min-max)
Total
Mean ± SD
Med (min-max)
p* p**
Group 1
Post term
(n = 94)
Group 2
Term
(n = 138)
PROM

(n = 59)
PIH

(n = 48)
HOUP

(n = 31)


(n = 232)
Age (years) 27.3 ± 5.9
27.0 (17.0-44.0)
28.4 ± 6.4
27.0 (17.0-46.0)
28.3 ± 6.3
27.0 (17.0-40.0)
29.5 ± 7.4
29.5 (17.0-46.0)
26.9 ± 4.7
26.0 (19.0-9.0)
28.0 ± 6.2
27.0 (17.0-46.0)
0.189 0.169
Gravidty 2.1 ± 1.5
2 (1-11)
2.7 ± 2.5
2 (1-15)
2.4 ± 2.2
1 (1-11)
3.3 ± 3.3
2 (1-15)
2.4 ± 1.6
2 (1-7)
2.5 ± 2.2
2 (1-15)
0.055 0.025
Parity 0.8 ± 1.3
0 (0-10)
1.3 ± 2.2
0 (0-11)
1.1 ± 1.9
0 (0-7)
1.8 ± 2.9
0.5 (0-11)
0.8 ± 1.2
0 (0-5)
1.1 ± 1.9
0 (0-11)
0.089 0.026
Abortus 0.3 ± 0.7
0.0 (0.0-3.0)
0.4 ± 0.8
0.0 (0.0-4.0)
0.3 ± 0.7
0.0 (0.0-4.0)
0.5 ± 0.8
0.0 (0.0-4.0)
0.7 ± 1.0
0.0 (0.0-3.0)
0.4 ± 0.8
0.0 (0.0-4.0)
0.297 0.089
Gestational age (week) 41.1 ± 0.4
41 (39-43)
38.5 ± 1.4
38.4 (36-40)
38.8 ± 1.4
39 (36-40)
38.2 ± 1.4
38.2 (36-40)
38.6 ± 1.2
38.5 (36-40)
39.5 ± 1.7
40.2 (36-43)
0.001 0.21
Birth Weight (g) 3500 ± 430
3460
(2720-5000)
3050 ± 500
3000
(1750-4300)
3170 ± 450
3200
(2400-4300)
3020 ± 560
2950
(1750-4110)
2870 ± 450
2800
(2000-3750)
3230 ± 520
3240
(1750-5000)
0.001 0.001
Table 2  — Primary and secondary outcomes of the study.
Groups
Mean ± SD
Median (min-max)
Subgroups of group 2
Mean ± SD
Median (min-max)
Total p* p**
Group 1 Postterm
(n = 94)
Group 2 Term
(n = 138)
PROM
(n = 59)
PIH
(n = 48)
HOUP
(n = 31)
(n = 232)
Interval of delivery (hour) 16.6 ± 9.5
13.3 (4.5-40)
16.0 ± 8.9
14 (3-47)
13.5 ± 7.0
12.5 (4-30)
18.7 ± 10.3
16.5 (3.5-47)
16.5 ± 8.9
13.5 (3-36)
16.3 ± 9.1
13.8 (3-47)
0.259 0.023
Interval of active phase(hour) 9.3 ± 6.7
7.5 (1-26)
9.6 ± 6.8
7 (1-28.5)
8.8 ± 6.7
6 (2-28.5)
11.0 ± 7.3
10 (1-24)
9.0 ± 6.5
6.8 (2-25)
9.5 ± 6.8
7.5 (1-28.5)
0.717 0.525
Success of induction n (%) 69 (73.4) 113 (81.9) 49 (83.1) 37 (77.1) 27 (87.1) 182 (78.4) 0.123 0.346
Table 3  — Maternal and neonatal outcomes.
Groups
n (%)
Subgroups of group 2
n (%)
p* p**
Group 1 Postterm
(n = 94)
Group 2 Term
(n = 138)
PROM
(n = 59)
PIH
(n = 48)
HOUP
(n = 31)
Asidosis 0 (0.0) 1 (0.7) 0 (0.0) 1 (2.1) 0 (0.0) 0.408 0.427
Meconium 8 (8.5) 2 (1.4) 0 (0) 1 (2.1) 1 (3.2) 0.09 0.119
Cesarean Section 22 (23.4) 18 (13.0) 8 (14.8) 6 (12.5) 4 (12.9) 0.040 0.294
Tachysystole 0 (0.0) 3 (2.2) 3 (5.6) 0 (0.0) 0 (0.0) 0.150 0.040
Hyperstimulation 0 (0.0) 1 (0.7) 1 (1.9) 0 (0.0) 0 (0.0) 0.408 0.507
Apgar score < 7
(At the 5th min)
3 (3.2) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 0.035 0.347
Postpartum hemorrhage 4 (4.3) 2 (1.4) 2 (3.7) 0 (0.0) 0 (0.0) 0.186 0.427
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