Labor induction in term nulliparous women with premature rupture of membranes: oxytocin versus dinoprostone

Abstract

Introduction Premature rupture of the membranes (PROM) refers to rupture of the fetal membranes prior to the onset of regular uterine contractions. Premature rupture of the membranes continues to be one of the most vexing issues of obstetrics due to increased maternal and fetal morbidity and mortality. Many studies have focused on how management should be in these cases. The purpose of this study was to investigate whether dinoprostone (PGE 2 analogue) administration is necessary for cervical ripening and labor induction in term women with premature rupture of membranes (PROM) and to compare maternal and neonatal outcomes between oxytocin usage and dinoprostone usage in PROM. Material and methods A total of 224 nulliparous singleton pregnant women at term, with PROM ≥ 12 h, vertex presentations, no prior uterine surgery, reactive non-stress test and Bishop scores ≤ 6 (unfavorable cervixes) were reviewed. Participants were divided into two groups as oxytocin and dinoprostone groups. The primary outcome was vaginal delivery within 24 h. Results The women in the oxytocin group were significantly younger than in the dinoprostone group (22.85 ±4.10 years vs. 25.99 ±4.94 years; p = 0.001). There were significant differences in vaginal delivery rates within 24 h. It was 72 of 112 (64.3%) vs. 53 of 112 (47.3%), p = 0.023 for oxytocin and dinoprostone groups, respectively. Conclusions Vaginal dinoprostone appears to be a relatively inefficient method of inducing labor compared with oxytocin in term pregnancies with PROM and unfavorable cervixes. However, dinoprostone may maintain uterine contractions as effectively as oxytocin once uterine contractions are established.

Dinoprostone pessary for labor induction in Chinese patients with premature rupture of membranes at term: A retrospective cohort

“…Similarly, in the study by Güngördük, an incidence of 7.6% was reported for term PROM women with excessive uterine activity who received sustained‐release dinoprostone followed by oxytocin infusion 6 h later 12 . However, in our study, the percentage of women with uterine hyperstimulation was 20.6% in the PGE2 group, which was consistent with the result of the study by Nur Gozde Kulhan et al 14 In that study, it was found that the rate of uterine hyperstimulation was 22.3% in Turkish term PROM patients with dinoprostone pessary.…”

“…The rates of cesarean delivery and induction failure were clearly decreased in the PGE2 group, which was consistent with the finding by Hingoro 13 . On the other hand, another study comparing vaginal dinoprostone with oxytocin infusion in the treatment of PROM with unfavorable cervixes at term found that the vaginal delivery rate within 24 h was smaller in patients with vaginal dinoprostone 14 . In the above research, patients with vaginal dinoprostone received no other labor induction methods, and not achieving active labor despite 12 h of continuous treatment with the vaginal dinoprostone was considered as induction failure, which was reported as the indication for cesarean delivery.…”

The role of dinoprostone for labor induction in postterm and high-risk term pregnancies

“…Muzorkevich et al [18] reviewed the role of oxytocin and prostaglandin derivatives in PROM and concluded that immediate labour induction by oxytocin provides an improved outcome status for patients with PROM at term.In a retrospective study evaluating the effect of dinoprostone and oxytocin in nulliparous women with term or preterm PROM on the delivery mode and delivery interval, the authors showed that the labour induction for PROM at term in nulliparous women with an unfavorable cervix resulted in a longer duration in the second stage, and an increased risk of cesarean delivery due to failure to progress, compared to those with intact membranes [19]. Oxytocin was found to be more successful in a study comparing the efficacy of oxytocin and dinoprostone in labor induction in the term, nulliparous, PROM pregnant women [20]. The inclusion of only nulliparous patients in this study may be associated with lower success rates.…”

Management of Prelabour Rupture of Membranes at Term, at Northland District Health Board.

“…Comparisons of methods of induction of labour following PROM were the focus of much of recent research related to PROM ( Prostaglandin pessary use was explored with mixed results in the studies by Güngördük et al (2012), Kulhan and Kulhan (2019), and Kunt et al (2010). Güngördük et al (2012) left the pessary in situ for up to six hours prior to commencing IV oxytocin, finding a higher rate of vaginal birth than oxytocin alone, with no difference in other maternal or neonatal outcomes.…”