Induction of labor with dinoprostone vaginal insert; is it safe and effective in term pregnancy with premature rupture of membranes?

Abstract

Objective: Our aim in this study is to compare the efficacy and safety of controlledrelease dinoprostone vaginal insert in patients with intact membranes and premature rupture of membranes (PROM). Material and Methods: Eighty-six term pregnants with singleton pregnancy, with no prior uterine scar, vertex presentation, bishop score = 5, were included in the study. Patients were divided into two groups as PROM patients (n:27) and patients with intact membranes (n:59). Labor induction with controlled-release dinoprostone vaginal insert was performed to all cases. The groups were compared with each other in terms of cervical ripening, success of the induction, adverse neonatal outcomes and presence of maternal side effects. Results: In the PROM group and the intact membrane group, the cervical ripening was completed at 4th hours and at 6th hours, respectively (p=0.01 and p=0.001). The mean time to onset of active labor was 6,63 hours in the PROM group and 7,81 hours in the intact membranes group (p=0.1). There was no significant difference in low 1. and 5. minute Apgar scores, low umbilical artery pH, administration to neonatal intensive care unit, and operative vaginal delivery between the two groups. Maternal vomiting, diarrhea, uterine tachysystole were not observed and there was no case of maternal or neonatal death. Conclusion: These data overall suggest that controlled-release dinoprostone insert use is effective and safe in patients with PROM just like in patients with intact membranes. Cop yright & 2016 by Tür ki ye Kli nik le ri.