Obesity and cervical ripening failure risk.

Area of Science:

• Obstetrics and Gynecology
• Reproductive Medicine
• Maternal-Fetal Medicine

Background:

• Cervical ripening is a critical step for labor induction.
• Obesity is a growing concern in obstetric populations.
• The impact of obesity on cervical ripening efficacy is not fully understood.

Purpose of the Study:

• To evaluate the association between obesity and cervical ripening success using prostaglandin E2 (PGE2).
• To compare PGE2 efficacy in obese versus normal-weight women.

Main Methods:

• Retrospective study comparing obese (BMI > 30 kg/m²) and normal-weight (BMI 20-25 kg/m²) patients.
• Standardized protocols for dinoprostone tampon (12h) or gel (6h) based on Bishop score.
• Defined cervical ripening failure as a Bishop score <6 after the initial treatment period.

Main Results:

• Obese patients had a significantly higher first-attempt cervical ripening failure rate (53.7%) compared to normal-weight patients (34.2%).
• Multivariate analysis identified BMI ≥ 30 (OR 2.32), parity ≤2 (OR 2.50), and low Bishop score ≤3 (OR 2.62) as independent predictors of ripening failure.
• Obesity was significantly associated with prostaglandin ripening failure (P=0.0019).

Conclusions:

• Obesity is independently associated with a higher risk of cervical ripening failure.
• Obesity appears to reduce cervical sensitivity to prostaglandin E2.
• Further research may explore alternative methods for cervical ripening in obese women.