| A randomized controlled trial of 24-hour vaginal dinoprostone pessary compared to gel for induction of labor in term pregnancies with a Bishop score < or = 4. | |
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MedLine Citation:
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PMID: 20199360 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To compare 24-hour controlled-release vaginal dinoprostone pessary vs. gel for induction of labor at term in women with an unfavorable cervix. DESIGN: Randomized controlled trial. SETTING: University hospital. POPULATION: A total of 133 women with singleton pregnancies, fetal cephalic presentation, Bishop score < or = 4, gestational age of 37-42 weeks, no previous cesarean section and intact membranes admitted for induction of labor. METHODS: Random allocation to either 24-hour 10-mg controlled-release vaginal dinoprostone pessary or repeat doses of 2 mg vaginal dinoprostone gel. MAIN OUTCOME MEASURES: Rate of spontaneous vaginal, operative vaginal and cesarean delivery. RESULTS: The rate of spontaneous vaginal delivery was significantly higher in the pessary group (72%) than in the gel group (54%), paralleled by a lower rate of operative vaginal deliveries (3 vs. 15%). The difference in cesarean section rate (25 vs. 31%) did not reach statistical significance. Both methods of induction of labor appeared to be safe, with no cases of 5-minute Apgar scores < 7 or episodes of uterine hyperstimulation in either group. The medication cost was lower in the pessary group, with a median saving of 50.20 euro compared to the gel group. CONCLUSIONS: Both the 24-hour dinoprostone vaginal pessary and the vaginal gel appear to be safe for labor induction. In women induced at term with a Bishop score < or = 4 the pessary achieved a significantly higher rate of spontaneous vaginal delivery. |
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Authors:
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Maria Teresa Triglia; Fabrizio Palamara; Andrea Lojacono; Federico Prefumo; Tiziana Frusca |
Publication Detail:
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Type: Comparative Study; Journal Article; Randomized Controlled Trial |
Journal Detail:
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Title: Acta obstetricia et gynecologica Scandinavica Volume: 89 ISSN: 1600-0412 ISO Abbreviation: Acta Obstet Gynecol Scand Publication Date: 2010 May |
Date Detail:
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Created Date: 2010-04-28 Completed Date: 2010-05-12 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0370343 Medline TA: Acta Obstet Gynecol Scand Country: England |
Other Details:
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Languages: eng Pagination: 651-7 Citation Subset: IM |
Affiliation:
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Maternal-Fetal Medicine Unit, Department of Obstetrics and Gynaecology, University of Brescia, Piazzale Spedali Civili 1, Brescia, Italy. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Administration, Intravaginal Adult Cervical Ripening / drug effects* Chi-Square Distribution Delayed-Action Preparations / administration & dosage Dinoprostone / administration & dosage* Female Gestational Age Humans Labor, Induced / methods* Oxytocics / administration & dosage* Pessaries Pregnancy Pregnancy Outcome* Pregnancy Trimester, Third Reference Values Risk Assessment Statistics, Nonparametric Term Birth Vaginal Creams, Foams, and Jellies |
| Chemical | |
Reg. No./Substance:
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0/Delayed-Action Preparations; 0/Oxytocics; 0/Vaginal Creams, Foams, and Jellies; 363-24-6/Dinoprostone |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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