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Oxytocin versus sustained‐release dinoprostone vaginal pessary for labor induction of unfavorable cervix with Bishop score ≥4 and ≤6: A randomized controlled trial
Author(s) -
Koc Onder,
Duran Bülent,
Ozdemirci Safak,
Albayrak Mustafa,
Koc Ummugulsum
Publication year - 2013
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/j.1447-0756.2012.02045.x
Subject(s) - dinoprostone , medicine , oxytocin , pessary , labor induction , bishop score , vaginal delivery , cervix , randomized controlled trial , pregnancy , obstetrics , anesthesia , prostaglandin e2 , surgery , cancer , biology , genetics
Aim To compare the efficacy and safety of high‐dose intravenous oxytocin and sustained‐release dinoprostone vaginal pessaries for cervical ripening and labor induction in pregnant patients at term with poor B ishop scores. Material and Methods Women at term with a B ishop score ≥4 and ≤6 were randomized into two groups to undergo induction of labor with either high‐dose oxytocin administered intravenously ( n = 90) or dinoprostone‐only vaginal pessary without oxytocin augmentation ( n = 90). The main outcome measures were rate of cesarean delivery, induction to delivery interval, number of deliveries achieved within 4, 8, 12, and 16 h of labor induction, maternal complications during induction, fetal outcome, and total hospital stay. In this study, per‐protocol analysis was performed. Results There were fewer cesarean deliveries with oxytocin compared to dinoprostone‐only groups (7/79 vs 14/89); however, the difference was not statistically significant. The induction–delivery intervals (7.9 h vs 12.0 h, P < 0.001; and 5.7 vs 10.4 h, P < 0.001; oxytocin vs dinoprostone‐only for primiparous and multiparous patients, respectively) were significantly shorter in oxytocin‐induced patients compared to dinoprostone‐only. A significantly higher percentage of patients delivered in the oxytocin group compared to the dinoprostone‐only group in 4, 8, 12, 16, and 20 h. Conclusion Intravenous oxytocin is effective to stimulate labor at term for patients with B ishop scores ≥4 and ≤6, with a shorter time interval from induction to vaginal delivery.