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DOI: 10.1055/s-0030-1271208
Retention of Dinoprostone Vaginal Insert Beyond 12 Hours for Induction of Labor
Publication History
Publication Date:
11 January 2011 (online)
ABSTRACT
We evaluate the likelihood of cesarean delivery and identify risks of retaining a sustained-release dinoprostone vaginal insert beyond 12 hours. In a secondary analysis of outcomes, data were collected during a large, randomized trial comparing different sustained-release prostaglandin vaginal inserts for labor induction. Outcomes were compared between cases in whom the dinoprostone insert was removed early (within 12 hours) or late (12 to 24 hours). A total of 431 subjects had the dinoprostone vaginal insert in place for 12 to 24 hours (n = 226, 52.4%) or within 12 hours (n = 205, 47.6%). Insert removal for labor complications was less frequent in the late group than in the early group (5.8% versus 21.5%; p ≤ 0.001). Abnormal uterine contractility patterns were less common in the late than early group (25.2% versus 37.6%; p = 0.03). Rates of cesarean delivery during the first hospitalization were similar for late and early groups (25.0% versus 29.2%; p = 0.33). Percentages of infants requiring immediate attention or intensive care were low and similar between groups. Sustained-release intravaginal dinoprostone left in place beyond 12 hours did not increase the risks of intrapartum complications, cesarean delivery, or immediate adverse neonatal events.
KEYWORDS
Induction of labor - cervical ripening - dinoprostone
REFERENCES
- 1 Rath W. A clinical evaluation of controlled-release dinoprostone for cervical ripening—a review of current evidence in hospital and outpatient settings. J Perinat Med. 2005; 33 491-499
- 2 Facchinetti F, Venturini P, Fazzio M, Volpe A. Elective cervical ripening in women beyond the 290th day of pregnancy: a randomized trial comparing 2 dinoprostone preparations. J Reprod Med. 2007; 52 945-949
- 3 Rayburn W F, Zhang J. Rising rates of labor induction: present concerns and future strategies. Obstet Gynecol. 2002; 100 164-167
- 4 Cervidil. Physician's Desk Reference, 63rd ed. Montvale, NJ: Physicians' Desk Reference; 2009: 1165-1167
- 5 Kalkat R K, McMillan E, Cooper H, Palmer K. Comparison of dinoprostone slow release pessary (Propess) with gel (Prostin) for induction of labour at term—a randomised trial. J Obstet Gynaecol. 2008; 28 695-699
- 6 Biem S R, Turnell R W, Olatunbosun O, Tauh M, Biem H J. A randomized controlled trial of outpatient versus inpatient labour induction with vaginal controlled-release prostaglandin-E2: effectiveness and satisfaction. J Obstet Gynaecol Can. 2003; 25 23-31
- 7 Wing D A. Misoprostol Vaginal Insert Consortium . Misoprostol vaginal insert compared with dinoprostone vaginal insert: a randomized controlled trial. Obstet Gynecol. 2008; 112 801-812
- 8 Calder A A, Embrey M P, Hillier K. Extra-amniotic prostaglandin E2 for the induction of labour at term. J Obstet Gynaecol Br Commonw. 1974; 81 39-46
- 9 Goharkhay N, Stanczyk F Z, Gentzschein E, Wing D A. Plasma prostaglandin E(2) metabolite levels during labor induction with a sustained-release prostaglandin E(2) vaginal insert. J Soc Gynecol Investig. 2000; 7 338-342
- 10 Lyrenäs S, Clason I, Ulmsten U. In vivo controlled release of PGE2 from a vaginal insert (0.8 mm, 10 mg) during induction of labour. BJOG. 2001; 108 169-178
- 11 Wing D A, Ortiz-Omphroy G, Paul R H. A comparison of intermittent vaginal administration of misoprostol with continuous dinoprostone for cervical ripening and labor induction. Am J Obstet Gynecol. 1997; 177 612-618
- 12 Khoury A N, Zhou Q P, Gorenberg D M, Nies B M, Manley G E, Mecklenburg F E. A comparison of intermittent vaginal administration of two different doses of misoprostol suppositories with continuous dinoprostone for cervical ripening and labor induction. J Matern Fetal Med. 2001; 10 186-192
Matthew BrennanM.D.
Department of Obstetrics and Gynecology, MSC10 5580
1 University of New Mexico, Albuquerque, NM 87131
Email: mcbrennan@salud.unm.edu