Labor induction: comparison between oxytocin and dinoprostone

Abstract

Labor induction is one of the most frequent procedures in pregnant women. The optimal regimen for preinduction cervical ripening and labor induction is not established. The aim of the present study was to compare the efficacy and safety of vaginal dinoprostone and intravenous oxytocin administration for labor induction. The medical records of the patients who had induction of labor at Okmeydanı Teaching and Research Hospital, Department of Obstetrics and Gynecology from January 2010 to June 2011 were evaluated retrospectively. The first group (143 patients) received a single dose of sustained-released dinoprostone 10 mg, which was inserted high into the vaginal fornix. The second group (151 patients) received intravenous oxytocin (synpitan). Maternal and fetal outcomes were compared. There were no significant differences between the two groups for parity, birth weight, fetal gender and mode of delivery. 195 (66.3%) of patiens had vaginal delivery and 99 (33.7%) had cesarean delivery. The median time from start of induction of labor to vaginal birth was longer when a prostaglandin E2 was used for labor induction than it was when oxytocin was used (20.1 hours vs 16.1 hours) (p<0.01). No maternal death or uterine rupture occurred. Neonatal weight, admission to neonatal unit, 1 and 5-minute Apgar score <7, did not differ significantly between two groups (p>0.05). Oxytocin is safe, effective and cost-effective treatment. The current study shows that sustained-released Dinoprostone which is an FDA (U.S. Food and Drug Administration) approved drug; is an alternative method for the induction of labor although it is not cost effective. Keywords: Cervical ripening; dinoprostone; labor induction; oxytocin. Özet

Contemporary Nursing Approaches in Induction of Labour

“…Of the Bishop score criteria for predicting successful induction, the most important is cervical dilatation, followed by effacement, station, and position, with the least important being consistency. The rate of failed induction is higher for women with a very low Bishop score (0 to 3) in both nulliparous and parous women 15,16 .…”