Effectiveness of prostaglandin E2 intracervical gel (Prepidil), with immediate oxytocin, versus vaginal insert (Cervidil) for induction of labor

Stewart, Jeffrey D.; Rayburn, William F.; Farmer, Kevin C.; Liles, Eleanor M.; Schipul, Arthur H.; Stanley, John R.

doi:10.1016/s0002-9378(98)70127-9

Cited by 38 publications

(26 citation statements)

References 9 publications

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“…Previous studies that used higher maximum oxytocin doses have not reported uterine hyperstimulation, further supporting the impression that concurrent oxytocin and vaginal prostaglandin for labor induction in women with an unfavorable cervix is safe [5,6,7,8]. The rate of uterine hyperstimulation for women in group B in our study was 8.4%, which is double the rate found in women in group A.…”

Section: Discussionsupporting

confidence: 85%

“…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: Discussionsupporting

confidence: 85%

Section: Introductionmentioning

confidence: 99%

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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show abstract

“…Based on an earlier study 12 that showed a 76 versus 56% vaginal delivery rate within 24 hours of commencement of labour induction with the use of concurrent oxytocin infusion and prostaglandin gel versus a sustained‐release prostaglandin vaginal insert, taking alpha of 0.05, power of 0.8 and a recruitment ratio of one to one, 97 women were needed in each arm for a suitably powered study with vaginal delivery within 24 hours as a primary outcome. Assuming a 10% drop out, a total of 216 women would need to be recruited.…”

Section: Methodsmentioning

confidence: 99%

“…There are few studies looking at concurrent oxytocin infusion with prostaglandin administration for cervical ripening and labour induction. We performed a PubMed search in all languages on 6 September 2006 using the terms ‘prostaglandins and oxytocin and labor induction and trial’ and found 408 entries, but only four entries related to concurrent use of oxytocin infusion with a prostaglandin for labour induction with intact membranes 9–12 . Three of these studies 10–12 have shown shorter induction‐to‐delivery interval with concurrent infusion of oxytocin with a prostaglandin agent at initiation of labour induction, but the largest of the four trials with 151 women did not demonstrate a significantly shorter induction‐to‐delivery interval with concurrent oxytocin infusion 9 …”

Section: Introductionmentioning

confidence: 99%

Concurrent oxytocin with dinoprostone pessary versus dinoprostone pessary in labour induction of nulliparas with an unfavourable cervix: a randomised placebo‐controlled trial

Tan

Valiapan

Tay

et al. 2007

BJOG

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Objective To compare concurrent oxytocin with dinoprostone pessary versus dinoprostone pessary in labour induction for nulliparas with an unfavourable cervix.Design A randomised double-blind study.Setting University Malaya Medical Centre, Malaysia.Population Nulliparas at term with intact membranes, Bishop score £ 6 and admitted for labour induction.Methods All women received 3 mg dinoprostone pessary for labour induction. Those randomised to the oxytocin arm received oxytocin infusion started at 1 mu/minute and doubled every 30 minutes to a maximum 16 mu/minute. Women assigned to placebo received identical volume of saline infusion. After 6 hours, infusion was stopped and vaginal reassessment performed to guide further management. Conclusions Labour induction with concurrent oxytocin infusion and vaginal dinoprostone could be considered for nulliparas with an unfavourable cervix. Larger studies are needed.

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“…In the present study induction to the delivery interval was prolonged in immediate induction group. However, study conducted by Stewart [4] PGE 2 gel immediate oxytocin regimen resulted in shorter induction delivery interval without adverse outcomes. The rate of CS in immediate induction group was 17.8% in the study by Snehamay, and 40% in the present study.…”

Section: Discussionmentioning

confidence: 94%

Premature Rupture of Membranes at Term: Immediate Induction With PGE2 Gel Compared With Delayed Induction With Oxytocin

Poornima

Reddy

2011

J Obstet Gynecol India

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Objectives To compare the effectiveness, safety of immediate induction with PGE 2 gel and expectant management in terms of maternal and fetal outcome in term PROM. Methods 100 women were randomized to group A, immediate induction and group B expectant management. Results Spontaneous vaginal deliveries were more in group B. CS and operative vaginal deliveries were more in group A. Conclusion Expectant management followed by delayed induction with oxytocin is better than immediate induction with PGE 2 gel in term PROM. A good number of women go into spontaneous labor and deliver vaginally with out increase in the Cesarean section rate and infectious morbidity for mother and fetus.

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Effectiveness of prostaglandin E2 intracervical gel (Prepidil), with immediate oxytocin, versus vaginal insert (Cervidil) for induction of labor

Cited by 38 publications

References 9 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

Concurrent oxytocin with dinoprostone pessary versus dinoprostone pessary in labour induction of nulliparas with an unfavourable cervix: a randomised placebo‐controlled trial

Premature Rupture of Membranes at Term: Immediate Induction With PGE2 Gel Compared With Delayed Induction With Oxytocin

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