Document Detail


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.
MedLine Citation:
PMID:  20199360     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Maria Teresa Triglia; Fabrizio Palamara; Andrea Lojacono; Federico Prefumo; Tiziana Frusca
Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Acta obstetricia et gynecologica Scandinavica     Volume:  89     ISSN:  1600-0412     ISO Abbreviation:  Acta Obstet Gynecol Scand     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-04-28     Completed Date:  2010-05-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370343     Medline TA:  Acta Obstet Gynecol Scand     Country:  England    
Other Details:
Languages:  eng     Pagination:  651-7     Citation Subset:  IM    
Affiliation:
Maternal-Fetal Medicine Unit, Department of Obstetrics and Gynaecology, University of Brescia, Piazzale Spedali Civili 1, Brescia, Italy.
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MeSH Terms
Descriptor/Qualifier:
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:
0/Delayed-Action Preparations; 0/Oxytocics; 0/Vaginal Creams, Foams, and Jellies; 363-24-6/Dinoprostone

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