Labor induction in term premature rupture of membranes: comparison between oxytocin and dinoprostone followed 6 hours later by oxytocin (original) (raw)
Related papers
Concurrent Dinoprostone and Oxytocin for Labor Induction in Term Premature Rupture of Membranes
Obstetrics & Gynecology, 2009
To estimate the effect of concurrent vaginal dinoprostone and oxytocin infusion against oxytocin infusion for labor induction in premature rupture of membranes (PROM) on vaginal delivery within 12 hours and patient satisfaction. METHODS: Nulliparas with uncomplicated PROM at term, a Bishop score less than or equal to 6, and who required labor induction were recruited for a doubleblind randomized trial. Participants were randomly assigned to 3-mg dinoprostone pessary and oxytocin infusion or placebo and oxytocin infusion. A cardiotocogram was performed before induction and maintained to delivery. Dinoprostone pessary or placebo was placed in the posterior vaginal fornix. Oxytocin intravenous infusion was commenced at 2 milliunits/min and doubled every 30 minutes to a maximum of 32 milliunits/min. Oxytocin infusion rate was titrated to achieve four contractions every 10 minutes. Primary outcomes were vaginal delivery within 12 hours and maternal satisfaction with the birth process using a visual analog scale (VAS) from 0 to 10 (higher score, greater satisfaction). RESULTS: One hundred fourteen women were available for analysis. Vaginal delivery rates within 12 hours were 25 of 57 (43.9%) for concurrent treatment compared with 27/57 (47.4%) (relative risk 0.9, 95% confidence interval 0.6-1.4, P)58.؍ for oxytocin only; median VAS was 8 (interquartile range [IQR] 2) compared with 8 (IQR 2), P.83.؍ Uterine hyperstimulation was 14% compared with 5.3%, P;02.؍ overall vaginal delivery rates were 59.6% compared with 64.9%, P;07.؍ and induction to vaginal delivery interval 9.7 hours compared with 9.4 hours P57.؍ for concurrent treatment compared with oxytocin, respectively. There was no significant difference for any other outcome. CONCLUSION: Concurrent vaginal dinoprostone and intravenous oxytocin for labor induction of term PROM did not expedite delivery or improve patient satisfaction.
Archives of Medical Science, 2018
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.
Journal of Evolution of Medical and Dental Sciences
BACKGROUND Management of Term Prelabour Rupture of Membranes (PROM) remains a matter of debate despite exhaustive research. Aims and Objectives-The objective of this study was to compare use of Tab. Misoprostol per vaginum versus Oxytocin infusion in PROM at term with respect to induction-delivery interval and maternal and foetal outcome. MATERIALS AND METHODS The present study was descriptive comparative study of Tab. Misoprostol (Group A) and Oxytocin infusion (Group B) for induction of labour in PROM at term. The study population consisted of 140 patients. RESULTS Mean induction delivery interval in present study was 541.06 ± 186 minutes in Group A and 556.69 + 219.54 minutes in Group B (p= 0.418), showing no significant difference between two groups. 8.6% women in Group A and 2.9% in Group B had hyperstimulation with no significant difference between the two. There was no significant difference in neonatal complications in the two groups. CONCLUSION The incidences of maternal and foetal untoward effects are similar with use of the two inducing agents with no significant difference in induction delivery interval. Vaginal administration of Misoprostol in a dose of 25 µg 6 hourly to maximum of four doses is an effective alternative of oxytocin for labour induction in term PROM, especially in low resource setups where storage facility for oxytocin and skilled staff for its titration is not available.
Journal of Clinical Medicine, 2022
Background: The aim of this study is to demonstrate that a double balloon catheter combined with oxytocin decreases time between induction of labor and delivery (TID) as compared to a vaginal dinoprostone insert in cases of premature rupture of membranes at term. Methods: This is a prospective, randomized, controlled trial including patient undergoing labor induction for PROM at term with an unfavorable cervix in Clermont-Ferrand university hospital. We compared the double balloon catheter over a period of 12 h with adjunction of oxytocin 6 h after catheter insertion versus dinoprostone vaginal insert. After device ablation, cervical ripening continued only with oxytocin. The main outcome was TID. Secondary outcomes concerned delivery mode, as well as maternal and fetal outcome, and were adjusted for parity. Results: 40 patients per group were randomized. Each group had similar baseline characteristics. The study failed to demonstrate reduced TID (16.2 versus 20.2 h, ES = 0.16 (−0.2...
Taiwanese Journal of Obstetrics & Gynecology, 2010
Objective: The aim of this study was to compare the efficacy and safety of a prostaglandin E 2 (PGE 2 ) vaginal insert with those of oxytocin for labor induction. The present study also examined whether its use reduces the rate of cesarean delivery in term pregnancies with premature rupture of membranes (PROM) and low Bishop scores. Materials and Methods: A total of 240 women with singleton pregnancies at ≥ 37 weeks, no prior uterine scar, vertex presentations, reactive nonstress tests, PROM for ≥ 12 hours and Bishop scores of ≤ 6 were randomly assigned to receive either oxytocin or vaginal PGE 2 . The primary outcomes were time from induction to delivery and mode of delivery. Results: The time from labor induction to active labor onset was significantly shorter in the oxytocin group than in the PGE 2 group (4.9 ± 4.1 vs. 8.5 ± 3.6 hours; p = 0.02). The time from induction to delivery was also significantly shorter in the oxytocin group (3.4 ± 1.5 vs. 9.6 ± 4.7 hours; p = 0.02). Cesarean delivery rates were statistically similar in the oxytocin and PGE 2 groups (18.3 vs. 20.0%; p = 0.81). Neonatal outcomes were comparable in both groups. Comparable results were observed for nulliparous women included in the study population. Conclusion: Oxytocin treatment seems to be superior to vaginal administration of PGE 2 to induce labor in term pregnancies complicated with PROM and unfavorable services. [Taiwan J Obstet Gynecol 2010;49(1):57-61]
Premature rupture of membranes at term: immediate induction of labor versus expectant management
2014
Objective : To compare the maternal outcomes of immediate induction of labor with expectant management in women presenting with premature rupture of membranes (PROM) at term. Methods : One hundred and fifty two women with PROM at term were randomized into either immediate induction of labor with oxytocin or expectant management for a period of 12 hours. The primary outcome measure was the incidence of clinical endometritis in each group. Secondary outcomes were the mode of delivery, the neonatal outcome and the proportion of women in the expectant management group that progressed to spontaneous labor. Results : The immediate induction arm had a lower caesarean section rate, (7.9% vs 28.9%, P=0.001), higher spontaneous vaginal delivery rate (92.1% vs 71.1%; P=0.001) and lower incidence of clinical endometritis (0% vs 5.3%, P=0.006), when compared with the expectant management arm. The estimated duration of labor was shorter in the expectant management arm (8.9±2.17hours vs 10.6±2.35h...
Duration of Oxytocin and Rupture of the Membranes Before Diagnosing a Failed Induction of Labor
Obstetrics and gynecology, 2016
To compare maternal and neonatal outcomes based on length of the latent phase during induction with rupture of membranes before 6 cm dilation. This is a retrospective cohort study using data from the Consortium of Safe Labor study, including 9,763 nulliparous and 8,379 multiparous women with singleton, term pregnancies undergoing induction at 2 cm dilation or less with rupture of membranes before 6 cm dilation after which the latent phase ended. Outcomes were evaluated according to duration of oxytocin and rupture of membranes. At time points from 6 to 18 hours of oxytocin and rupture of membranes, the rates of nulliparous women remaining in the latent phase declined (35.9-1.4%) and the rates of vaginal delivery for those remaining in the latent phase at these time periods decreased (54.1-29.9%) Nulliparous women remaining in the latent phase for 12 hours compared with women who had exited the latent phase had significantly increased rates of chorioamnionitis (12.1% compared with 4....
Journal of SAFOG, 2016
Objectives To compare the efficacy, side effects and safety of oral misoprostol to intravenous oxytocin infusion for induction of labor in prelabor rupture of membranes (PROM). Materials and methods Two hundred and sixty-six women of prelabor rupture of membranes were assigned to receive either oral misoprostol 100 μg 6 hourly to a maximum 3 doses (misoprostol group, n = 142), or escalating doses of oxytocin infusion up to 20 mIU/min in primigravida and up to 10 mIU/min in multigravida (oxytocin group, n = 114). Results Demographic characteristics were similar in both the groups. The difference in mean induction to delivery interval (8.2 ± 6 hours in misoprostol group vs 12.2 ± 6 hours in oxytocin group) was statistically significant when two groups were compared. The incidence of vaginal delivery (86.1% in misoprostol group vs 84.2% in oxytocin group), and cesarean delivery (13.9% in misoprostol group vs 15.8% in oxytocin group), was almost similar in both the groups. The indicatio...
BMJ Open, 2019
IntroductionPremature rupture of membranes (PROM) occurs at term in 8% of pregnancies. Several studies have demonstrated that the risk of chorioamnionitis and neonatal sepsis increases with duration of PROM. Decreasing the time interval between PROM and delivery is associated with lower rates of maternal infections. In case of an unfavourable cervix, the use of prostaglandin for cervical maturation demonstrates some advantages over oxytocin. The use of double balloon catheter in reduction of PROM duration has not been evaluated in the literature.Methods and analysisWe are conducting a prospective, monocentric, randomised clinical trial on pregnant women with an unfavourable cervix showing PROM at term (RUBAPRO).After 12–24 hours of PROM, women are randomly assigned to one group treated with a double balloon catheter for 12 hours, with oxytocin administered after 6 hours or to the control group treated with 24 hours of vaginal prostaglandin followed by oxytocin infusion alone. Patien...
Prelabour rupture of membranes at term: early induction of labour versus expectant management
European Journal of Obstetrics & Gynecology and Reproductive Biology, 1996
Ol?/ectives: To compare expectant management with early induction of labour in pregnant patients with prelabour rupture of membranes at term and unfavourable cervix. Stud 3, design: A prospective, randomised study of 154 women with prelabour rupture of membranes at term of whom 80 had been managed expectantly, and 74 had undergone oxytocin induction at a rate of 2.5 mU/min. Digital examination was not performed before oxytocin infusion, and the first was delayed until 4 h (nulliparae), or 2 h (multiparae) of regular uterine contractions. Results: The mean period from rupture of membranes to delivery was significantly shorter in the induction group. The mean duration of labour was significantly shorter in the expectant group. Operative vaginal deliveries were more common in the induction group, and fetal distress was the most common cause of operative vaginal deliveries. The caesarean rates were low and similar in both groups. Maternal and neonatal infectious morbidity was similar and no difference was found in the length of hospitalisation. Conclusions: Expectant management in patients with ruptured membranes at term is safe and reduces the frequency of operative vaginal deliveries.