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Dinoprostone vaginal pessary for induction of labour: Safety of use for up to 24 h
Author(s) -
Tathem Kellie,
Harris Lisa J.,
O'Rourke Peter,
Kimble Rebecca M.
Publication year - 2012
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1111/j.1479-828x.2012.01482.x
Subject(s) - medicine , dinoprostone , pessary , obstetrics , bishop score , uterine rupture , labor induction , pregnancy , induction of labor , gynecology , prostaglandin e2 , oxytocin , uterus , cervix , cancer , biology , genetics
Background Cervidil ® (dinoprostone) intravaginal pessaries are used for induction of labour and maintain serum prostaglandin levels for up to 24 h. The Therapeutic Goods Administration approves Cervidil ® for 12‐h use. However, twenty‐four‐hour use of Cervidil ® is supported in Europe, New Zealand, America and some Australian hospitals. Aim To assess the safety of Cervidil ® use for up to 24 h for induction of labour in nulliparous women. Methods A retrospective cohort study of 269 consecutive women receiving Cervidil ® at the Royal Brisbane and Women's Hospital ( RBWH ) between July 2007 and December 2008 was performed. The primary outcome measures were frequency of, and time to, uterine tachysystole with or without fetal heart rate ( FHR ) changes. Secondary outcome measures included frequency of maternal (intrapartum temperature, postpartum haemorrhage) and neonatal (low Apgars, resuscitation, nursery admission) morbidity. Morbidity outcomes of those who received Cervidil ® for less than or equal to 12 h were compared with those who received Cervidil ® for more than 12 h. Results Uterine tachysystole occurred in 9.3% of patients receiving Cervidil ® , with a mean time to tachysystole of 10 h. The majority of cases (68%) occurred within 12 h of use. There was no increase in maternal or neonatal morbidity for those who received Cervidil ® for longer than 12 h. Conclusion Twenty‐four‐hour use of Cervidil ® is likely as safe as 12‐h use for induction of labour in nulliparous women.