Safety of low-dose prostaglandin E2 induction in grandmultiparous women with previous cesarean delivery. (March 2014)

• Record Type: Journal Article
• Authors: Haas, Jigal; Barzilay, Eran; Chayen, Benny; Lebovitz, Oshrit; Yinon, Yoav; Mazaki-Tovi, Shali; Harel, Linda
• Is Part Of: Journal of maternal-fetal & neonatal medicine. Volume 27:Number 5(2014:May)
• Page Start: 445
• Page End: 448
• Publication Date: 2014-03
• Subjects: Obstetrics -- Periodicals; Perinatology -- Periodicals; Infants (Newborn) -- Diseases -- Periodicals; Neonatology -- Periodicals; 618.2
• DOI: 10.3109/14767058.2013.818651
• Languages: English
• ISSNs: 1476-7058

Abstract

<abstract> <title>Abstract</title> <p> <italic>Objective</italic>: To determine the safety and efficacy of labor induction with low-dose vaginal prostaglandin E2 (PGE2) in grandmultiparous women with a previous cesarean delivery.</p> <p> <italic>Methods</italic>: We conducted a retrospective cohort study of 219 grandmultiparous women with a previous cesarean delivery (study group) who underwent induction of labor with low dose PGE2. These patients were compared to 1376 grandmultiparous women without a previous cesarean section (control group) who underwent induction of labor with low dose PGE2. The primary outcome was uterine rupture and secondary outcomes included mode of delivery, post-partum hemorrhage (PPH) and a low 5-min Apgar score (≤7).</p> <p> <italic>Results</italic>: One patient in the study group as well as one patient in the control group were diagnosed with uterine rupture (0.4% versus 0.07%). In the study group, vaginal delivery was achieved in 204 (93.16%) patients, whereas 15 (6.84%) patients had emergent cesarean delivery. Five minutes Apgar score ≤7 was recorded in two cases (0.9%) in the study group. Patients in the study group had a significantly higher rate of cesarean delivery (6.84%, versus 3.4%, respectively, <italic>p</italic> < 0.001) as well as operative vaginal delivery (4.56% versus 2% respectively, <italic>p</italic> < 0.05) compared to the control group. There were no significant differences between the groups regarding the rate of PPH (0.91% versus 0.90%, <italic>p</italic> = 0.2) or 5-min Apgar score ≤7 (0.91% versus 0.22%, <italic>p</italic> = 0.28).</p> <p> <italic>Conclusions</italic>: Low dose PGE2 is a relative safe method for induction of labor in grandmultiparous women with a previous cesarean section.</p> </abstract>