Single versus double application of vaginal dinoprostone: maternal factors affecting responsiveness. (17th December 2022)

• Record Type: Journal Article
• Authors: Sarno, Laura; Tesauro, Marina; Carlea, Annunziata; Quaglia, Filomena; Maruotti, Giuseppe Maria; Pannella, Gelsomina; Trezza, Gennaro; Guida, Maurizio
• Is Part Of: Journal of maternal-fetal & neonatal medicine. Volume 35:Number 24(2022)
• Page Start: 4763
• Page End: 4767
• Publication Date: 2022-12-17
• Subjects: Dinoprostone -- labor induction -- obesity -- maternal factor -- spontaneous delivery; Obstetrics -- Periodicals; Perinatology -- Periodicals; Infants (Newborn) -- Diseases -- Periodicals; Neonatology -- Periodicals; 618.2
• DOI: 10.1080/14767058.2020.1863367
• Languages: English
• ISSNs: 1476-7058

Abstract

Abstract: Purpose: The aim of our study was to identify maternal characteristics of women who are responsive to the second application of vaginal dinoprostone in a cohort of patients with a low Bishop Score. Secondarily, we compared the outcome of the patients' response to a single application to that of the women's response to a double application. Materials and methods: This was a retrospective observational cohort study. Patients undergoing preinduction of labor with dinoprostone 10mg controlled-release vaginal device were included. Results: Among 216 included patients, 192 women (88.9%) achieved a cervical ripening after a single application of dinoprostone, while 24 (11.1%) required a second application. Patients notresponding to the first application of dinoprostone had a significantly higher body mass index (27.4 ± 6.7 kg/m 2 vs 24.9 ± 5.2 kg/m 2 ; p < 0.05) and a significant increase in gestational weight gain (14 ± 5.2 kg vs 11.6 ± 6.1; p < 0.005). Double application of dinoprostone resulted in spontaneousdelivery in 58.4% of cases, but it was related to poorer neonatal outcome, compared to a single application. Conclusions: Obese women, not responding to the first application of dinoprostone could respond to the second application of this vaginal prostaglandin. However, data related to the use of a double application are still very limited to recommend its use as a standardized procedurefor not responsive patients.