Randomized trial of concurrent oxytocin with a sustained-release dinoprostone vaginal insert for labor induction at term

Christensen, Franklyn C.; Tehranifar, Mitra; González, Jose L.; Qualls, Clifford; Rappaport, Valerie J.; Rayburn, William F.

doi:10.1067/mob.2002.118309

Cited by 28 publications

(30 citation statements)

References 4 publications

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“…The interval from induction to delivery was 13.95 ± 4.53 h in group B. This time interval was shorter than reported in other studies of patients who underwent induction of labor with dinoprostone vaginal pessary with or without oxytocin [6,7,8,10]. A possible explanation for this difference is the dose of oxytocin which was used in our study.…”

Section: Discussioncontrasting

confidence: 51%

“…The incidence of vaginal delivery was 93.2% in group B which was higher than in group A. This ratio was higher than reported in other studies of patients who underwent induction of labor with dinoprostone vaginal pessary with or without oxytocin [6,8,10]. …”

Section: Discussioncontrasting

confidence: 50%

“…There are 5 studies on concurrent oxytocin infusion with prostaglandin administration for cervical ripening and labor induction [4,5,6,7,8]. Three of these studies have shown a shorter induction-to-delivery interval with concurrent oxytocin infusion with a prostaglandin agent at the initiation of labor, but the other 2 studies did not demonstrate a significantly shorter induction-to-delivery interval with concurrent oxytocin infusion [4,5,6,7,8]. However, in all of these studies the concurrent oxytocin infusion period and study populations were different.…”

Section: Introductionmentioning

confidence: 99%

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Sustained-Release Dinoprostone Vaginal Pessary with Concurrent High-Dose Oxytocin Infusion Compared to Sustained-Release Dinoprostone Vaginal Pessary Followed 6 h Later by High-Dose Oxytocin Infusion for Labor Induction in Women at Term with Unfavorable Cervix: A Randomized Controlled Trial

Güngördük

Yıldırım²,

Güngördük³

et al. 2010

Gynecol Obstet Invest

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Objective: To compare the efficacy and safety of sustained-release dinoprostone vaginal pessary and concurrent high-dose oxytocin infusion with sustained-release dinoprostone vaginal pessary followed 6 h later by high-dose oxytocin infusion for cervical ripening and labor induction. Methods: A total of 500 nulliparous or multiparous women with a singleton pregnancy, Bishop score ≤4 and admitted for labor induction. Women were randomly assigned to induction of labor using intravaginal dinoprostone with concurrent high-dose oxytocin (n = 250) or intravaginal dinoprostone pessary followed 6 h later by high-dose oxytocin (n = 250). The primary outcome was the number of vaginal deliveries achieved within 24 h of labor induction. Results: Baseline characteristics of both groups were comparable. Vaginal delivery within 24 h of labor induction was significantly increased with sustained-release dinoprostone followed 6 h later by high-dose oxytocin infusion (92.8 vs. 82.0%, RR 2.82, 95% CI 1.58–5.04). There were more cesarean section deliveries in the dinoprostone with concurrent high-dose oxytocin group (16.8 vs. 6.8%, RR 0.36, 95% CI 0.20–0.65). Maternal outcomes did not differ significantly. An Apgar score of <7 at 5 min was found more often in the dinoprostone with concurrent high-dose oxytocin group (3.6%) in comparison to dinoprostone pessary followed 6 h later by high-dose oxytocin (0.8%), although this was not statistically different (RR 0.21, 95% CI 0.04–1.01). Conclusion: Sustained-release dinoprostone followed 6 h later by high-dose oxytocin infusion appears to be safer and more effective than sustained-release dinoprostone with concurrent high-dose oxytocin infusion in achieving cervical ripening and successful vaginal delivery.

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Section: Discussioncontrasting

confidence: 51%

Section: Discussioncontrasting

confidence: 50%

Section: Introductionmentioning

confidence: 99%

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Sustained-Release Dinoprostone Vaginal Pessary with Concurrent High-Dose Oxytocin Infusion Compared to Sustained-Release Dinoprostone Vaginal Pessary Followed 6 h Later by High-Dose Oxytocin Infusion for Labor Induction in Women at Term with Unfavorable Cervix: A Randomized Controlled Trial

Güngördük

Yıldırım²,

Güngördük³

et al. 2010

Gynecol Obstet Invest

View full text Add to dashboard Cite

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“…Thus, the use of oxytocin to assist labor does not have negative effects on the fetus (11,13). Intracervical or intravaginal application of dinoprostone (PGE 2 ) is also frequently used to induce labor (5,6,10). Long term treatment with low-dose controlled dinoprostone was well tolerated by both the mother and the fetus (14), with uterine hyperstimulation rates of 7.4-7.8% and fetal distress rates of 10.9-26% (5,12).…”

Section: Discussionmentioning

confidence: 99%

“…Oxytocin is a safe and efficient starter of uterine contractions, but its success is associated with the condition of the cervix at the start of the labor. Dinoprostone (PGE 2 ) is used to turn an unfavorable to a favorable cervix before the induction of labor (6,7).…”

Section: Introductionmentioning

confidence: 99%

Effects of intravaginally inserted controlled-release dinoprostone and oxytocin for labor induction on umbilical cord blood gas parameters

Keskin¹,

Kabacaoğlu²,

Seçen³

et al. 2012

J Turkish German Gynecol Assoc

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Objective:To compare the effects of oxytocin and dinoprostone used in labor induction on fetal blood gas parameters. Material and Methods: This prospective randomized trial involved108 women who completed 37 gestational weeks and who required labor induction prior to normal vaginal birth. Labor was induced in 57 women with an intravenous low dose oxytocin regimen and in 51 with intravaginal dinoprostone (PGE 2 ). Following childbirth, umbilical artery blood gas was analyzed, with pH, pCO 2 , pO 2 , HCO 3 and base excess (BE) compared in the two groups.Results: Mean age and obstetrical data (gravidity, parity, gestational weeks and birthweight) were similar in the two groups (p>0.05). All infants had 1 and 5 minute APGAR scores ≥7. Umbilical artery blood pH was similar in the oxytocin and dinoprostone groups (7.31±0.07 vs. 7.31±0.05, p=0.780), as were the other blood gas parameters (pCO 2 , pO 2 , base excess and HCO 3 ; p>0.05 each). Conclusion:Induction of labor with either oxytocin or dinoprostone in women with uncomplicated term pregnancies had no adverse effects on umbilical artery blood gas parameters. (J Turkish-German Gynecol Assoc 2012; 13: 257-60) Key words: Oxytocin, dinoproston, umbilical artery blood gas, labor induction, pH Received: 13 August, 2012 Accepted: 18 November, 2012 Amaç: Bu çalışmada amacımız, doğum indüksiyonunda kullanılan iki metod olan oksitosin ve dinoprostonun fetal kan gazı parametreleri üzerine olan etkilerinin karşılaştırılmasıdır. Gereç ve

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Intravenous oxytocin alone for cervical ripening and induction of labour

Alfirević

Kelly

Dowswell

2009

Cochrane Database of Systematic Reviews

155

129

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Background Oxytocin is the commonest induction agent used worldwide. It has been used alone, in combination with amniotomy or following cervical ripening with other pharmacological or non-pharmacological methods. Objectives To determine the effects of oxytocin alone for third trimester cervical ripening and induction of labour in comparison with other methods of induction of labour or placebo/no treatment. Search methods We searched the Cochrane Pregnancy and Childbirth Group’s Trials Register (January 2009) and bibliographies of relevant papers. Selection criteria Randomised and quasi-randomised trials comparing intravenous oxytocin with placebo or no treatment, or with prostaglandins (vaginal or intracervical) for third trimester cervical ripening or labour induction. Data collection and analysis Two review authors independently assessed eligibility and carried out data extraction. Main results Sixty-one trials (12,819 women) are included. When oxytocin inductions were compared with expectant management, fewer women failed to deliver vaginally within 24 hours (8.4% versus 53.8%, risk ratio (RR) 0.16, 95% confidence interval (CI) 0.10 to 0.25). There was a significant increase in the number of women requiring epidural analgesia (RR 1.10, 95% CI 1.04 to 1.17). Fewer women were dissatisfied with oxytocin induction in the one trial reporting this outcome (5.9% versus 13.7%, RR 0.43, 95% CI 0.33 to 0.56). Compared with vaginal prostaglandins, oxytocin increased unsuccessful vaginal delivery within 24 hours in the two trials reporting this outcome (70% versus 21%, RR 3.33, 95% CI 1.61 to 6.89). There was a small increase in epidurals when oxytocin alone was used (RR 1.09, 95% CI 1.01 to 1.17). Most of the studies included women with ruptured membranes, and there was some evidence that vaginal prostaglandin increased infection in mothers (chorioamnionitis RR 0.66, 95% CI 0.47 to 0.92) and babies (use of antibiotics RR 0.68, 95% CI 0.53 to 0.87). These data should be interpreted cautiously as infection was not pre-specified in the original review protocol. When oxytocin was compared with intracervical prostaglandins, there was an increase in unsuccessful vaginal delivery within 24 hours (50.4% versus 34.6%, RR 1.47, 95% CI 1.10 to 1.96) and an increase in caesarean sections (19.1% versus 13.7%, RR 1.37, 95% CI 1.08 to 1.74) in the oxytocin group. Authors’ conclusions Comparison of oxytocin with either intravaginal or intracervical PGE2 reveals that the prostaglandin agents probably increase the chances of achieving vaginal birth within 24 hours. Oxytocin induction may increase the rate of interventions in labour. A suggestion that for women with prelabour rupture of membranes induction with vaginal prostaglandin may increase risk of infection for mother and baby warrants further study.

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Randomized trial of concurrent oxytocin with a sustained-release dinoprostone vaginal insert for labor induction at term

Cited by 28 publications

References 4 publications

Sustained-Release Dinoprostone Vaginal Pessary with Concurrent High-Dose Oxytocin Infusion Compared to Sustained-Release Dinoprostone Vaginal Pessary Followed 6 h Later by High-Dose Oxytocin Infusion for Labor Induction in Women at Term with Unfavorable Cervix: A Randomized Controlled Trial

Sustained-Release Dinoprostone Vaginal Pessary with Concurrent High-Dose Oxytocin Infusion Compared to Sustained-Release Dinoprostone Vaginal Pessary Followed 6 h Later by High-Dose Oxytocin Infusion for Labor Induction in Women at Term with Unfavorable Cervix: A Randomized Controlled Trial

Effects of intravaginally inserted controlled-release dinoprostone and oxytocin for labor induction on umbilical cord blood gas parameters

Intravenous oxytocin alone for cervical ripening and induction of labour

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