Induction of labor in patients with previous cesarean section using two different forms of vaginal dinoprostone

Abstract

BackgroundInduction of labor (IOL) in women who have undergone a prior cesarean section (CS) is an alternative to mitigate subsequent CS. The aim of this study was to evaluate the efficacy and safety of two different forms of vaginal dinoprostone (1.5 and 3 mg vaginal tablets) for IOL in patients who have undergone one previous CS. Materials and methodsThis pilot study was conducted in Minia University Hospital, Egypt. Eighty pregnant women who had undergone one previous CS were randomized to receive vaginal dinoprostone 1.5 or 3 mg for IOL. The outcome measures were compared. Results Use of dinoprostone 3 mg was associated with higher number of vaginal delivery, less oxytocin use, and shorter induction-delivery interval compared with 1.5 mg dose. The differences were not statistically significant. Out of 80 patients planned for IOL, 52 (65%) delivered vaginally and 28 (35%) underwent a CS. Maternal morbidity did not differ significantly between the two groups. Uterine dehiscence was diagnosed in only one patient (1.2%). Three cases had atonic postpartum hemorrhage. ConclusionThe two forms of dinoprostone vaginal tablets had comparable efficacy and safety profile when used for IOL in women who had undergone a previous CS. A larger, multicenter, randomized, controlled study is recommended.