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Obstetric Use of Prostaglandin Preparations Compared to Mechanical Methods for Cervical Ripening in Pregnancies With
Nobuko Yokoyama1, Shunji Suzuki2
1Obstetrics and Gynecology, Nippon Medical School, Tokyo, JPN.
Background We examined the difference in obstetric outcomes between the cases using dinoprostone and those using mechanical methods in pregnant women requiring cervical ripening following premature rupture of the membranes (PROMs) at term. Methodology During the study period, dinoprostone was used in 34 nulliparous women, while mechanical methods were used in 35 nulliparous women for cervical ripening following PROM at term. We examined the differences in the delivery outcomes between the two groups. Results On the day of induction start, 2 cases (6%) in the dinoprostone group were delivered by cesarean section due to non-reassuring fetal status (NRFS), while no cases were complicated by NRFS in the mechanical methods group (P = 0.15). However, there was no significant difference in the rate of cesarean delivery between the two groups (P = 0.73). In the mechanical methods groups, 3 cases (9%) were complicated by clinical intrauterine infection, while there was no case of clinical intrauterine infection in the dinoprostone group (P = 0.08). The clinical intrauterine infection in the cases of the mechanical methods group occurred more than 2 days after the start of cervical ripening; however, there was no case of neonatal infection in the two groups. Conclusions There were differences in the characteristics of the effects between the two methods in pregnant women with PROM who have an unfavorable cervix; however, there were no differences in the final perinatal outcome.
Background We examined the difference in obstetric outcomes between the cases using dinoprostone and those using mechanical methods in pregnant women requiring cervical ripening following premature rupture of the membranes (PROMs) at term. Methodology During the study period, dinoprostone was used in 34 nulliparous women, while mechanical methods were used in 35 nulliparous women for cervical ripening following PROM at term. We examined the differences in the delivery outcomes between the two groups. Results On the day of induction start, 2 cases (6%) in the dinoprostone group were delivered by cesarean section due to non-reassuring fetal status (NRFS), while no cases were complicated by NRFS in the mechanical methods group (P = 0.15). However, there was no significant difference in the rate of cesarean delivery between the two groups (P = 0.73). In the mechanical methods groups, 3 cases (9%) were complicated by clinical intrauterine infection, while there was no case of clinical intrauterine infection in the dinoprostone group (P = 0.08). The clinical intrauterine infection in the cases of the mechanical methods group occurred more than 2 days after the start of cervical ripening; however, there was no case of neonatal infection in the two groups. Conclusions There were differences in the characteristics of the effects between the two methods in pregnant women with PROM who have an unfavorable cervix; however, there were no differences in the final perinatal outcome.
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