A prospective randomized comparative study between Sustained release vaginal insert and intracervical gel in women with unfavourable cervix at term pregnancy
Keywords:
labour, bishop score, hyperstimulation, dinoprostone, intracervical gel, apgar scoreAbstract
Background-Induction of Labour (artificially initiated labour) is a common obstetric practice in pregnant women throughout the world, accounting for 20% of all births. Induction of Labour should be performed only when there is a clear medical indication for it and the expected benefits overweigh its potential harms. Objectives- to compare between the two formulations of dinoprostone and study the better option among the two, in cervical ripening and labour induction in women with unfavourable cervix. Methods- It was a Prospective randomized comparative study done in total 100 consecutive term pregnant women who underwent labor induction for fetal or maternal indications were divided randomly into two groups. Group A - sustained release vaginal insert and Group B - Intracervical gel. Informed consent was taken from each patient. SPSS (Version 22.0) was used for analysis. Results- Statistically significant increase in final Bishop’s score (p=0.01) and hyperstimulation (p=0.04) was seen in Vaginal insert group as compared to Intracervical gel group, while there were no statistically significant differences in maternal outcomes, neonatal outcomes and need for oxytocin augmentation in both groups.
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References
Rayburn WF. Clinical experience with a controlledrelease, prostaglandin E2 intravaginal insert in the USA. Br J Obstet Gynaecol. 2007;104 Suppl 15:8- 12.
Kelly AJ, Kavanagh J, Thomas J. Vaginal prostaglandin (PGE2 and PGF2a) for induction of labour at term. Cochrane Database Syst Rev. 2013;CD003101.
Keirse MJNC. Natural prostaglandins for induction of labor and preinduction cervical ripening. Clin Obstet Gynecol. 2016;49:609-26.
Kelly AJ, Malik S, Smith L, Kavanagh J, Thomas J. Vaginal prostaglandin (PGE2 and PGF2a) for induction of labour at term. Cochrane Database Syst Rev. 2019;CD003101. 5. Wieland D, Friedman F. Comparing two dinoprostone agents for preinduction cervical ripening at term. A randomized trial. J Reprod Med. 2009;44:724-8.
Chyu JK, Strassner HT. Prostaglandin E2 for cervical ripening: a randomized comparison of Cervidil versus Prepidil. Am J Obstet Gynecol. 2007;177:606-11
Marconi AM, Bozzetti P, Morabito A, et al. Comparing two dinoprostone agents for cervical ripening and induction of labor: a randomized trial. Eur J Obstat Gynecol Reprod Biol. 2018;138:135-40.
Mukhopadhyay M, Lim KJH, Fairlie FM. Is propess a better method of induction of labour in nulliparous women. J Obstet Gynaecol. 2012;22:294-5.
Ottinger WS, Menard MK, Brost BC. A randomized clinical trial of prostaglandin E2 intracervical gel and a slow release vaginal pessary for preinduction cervical ripening. Am J Obstet Gynecol. 2008;179:349-53.
Facchinetti F, Venturini P, Verocchi G, Volpe A. Comparison of two preparations of dinoprostone for pre-induction of labour in nulliparous women with very unfavourable cervical condition: a randomised clinical trial. Eur J Obstet Gynecol Reprod Bio. 2015;119:189-93.
Westgate J, Williams JA. Evaluation of a controlled release vaginal prostaglandin E2 pessary with a retrieval system for the induction of labour. J Obstet Gynaecol. 2014;14:146-50.
Trofatter KF, Bowers D, Gall SA, Killam AP. Preinduction cervical ripening with prostaglandin E2 (Prepidil) gel. Am J Obstet Gynecol. 2013;153(3):268-71.
Mazouni C, Provensal M, Ménard JP. Utilisation du dispositif vaginal Propess dans le déclenchementdu travail: efficacité et innocuité. Gynéco ObstétFertil. 2016;34:489-92.
Pevzner L, Alfirevic Z, Powers BL.Cardiotocographic abnormalities associated withmisoprostol and dinoprostone cervical ripening andlabor induction. Eur J Obstet Gynecol Reprod Biol.2011;156:144-8.
Vollebregt A, van’t Hof DB, Exalto N. Prepidilcompared to Propess for cervical ripening. Eur JObstet Gynecol Reprod Biol. 2012;104:116-9.
Strobelt N, Meregalli V, Ratti M. Randomized studyon removable PGE2 vaginal insert versus PGE2cervical gel for cervical priming and labor inductionin low-Bishop-score pregnancy. Acta Obstetricia etGynecologica Scandinavica 2016; 85: 302–305.
El-Shawarby SA, Connell RJ. Induction of labour atterm with vaginal prostaglandins preparations: Arandomised controlled trial of Prostin versus Propess.J Obstet Gynaecol. 2016;26:627-30.
Rugarn O, Tipping D, Powers B, Wing DA.Induction of labour with retrievable prostaglandinvaginal inserts: outcomes following retrieval due toan intrapartum adverse event. An Inter J ObstetGynaecol. 2017;124:796-803.
Suryasa, I. W., Rodríguez-Gámez, M., & Koldoris, T. (2022). Post-pandemic health and its sustainability: Educational situation. International Journal of Health Sciences, 6(1), i-v. https://doi.org/10.53730/ijhs.v6n1.5949
Herliah, A., Baso, Y. S., Hidayanty, H., Syarif, S., Aminuddin, A., & Bahar, B. (2022). Effect of web-based she smart education models on adolescent girl’s knowledge, attitudes, and practice about obesity. International Journal of Health & Medical Sciences, 5(1), 50-55. https://doi.org/10.21744/ijhms.v5n1.1832
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