Mechanical methods for induction of labor

Gupta, Janesh; Baev, Baev O.R.; Gómez, Jorge; Garabédian, Charles; Hellmeyer, L; Mahony, Rhona; Maier, Jutta; Pařı́zek, Antonı́n; Radzinsky, V.E.; Jørgensen, Jan Stener; Wennerholm, Ulla-Britt; Renzo, Gian Carlo Di

doi:10.1016/j.ejogrb.2021.10.023

Cited by 10 publications

(18 citation statements)

References 46 publications

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“…9,39 Key advantages of cervical osmotic dilators over dinoprostone comprise: (1) analogous or slightly superior obstetricrelated efficacy, (2) absence of drug-associated side effects, such as fever, (3) reduced hazards of maternal-fetal complications, such as uterine hyperstimulation and abnormal fetal heart rates, (4) better safety profile in patients with previous cesarean delivery or at risk of uterine rupture, (5) lower health care-related cost, and (6) easier to administer and remove. 9 These cervical osmotic dilators are available in natural (laminaria) and synthetic (dilapan, dilapan-S, and lamicel) preparations. 8,9 Blumenthal and Ramanauskas conducted an RCT among patients undergoing labor induction and revealed that dilapan-S appeared to be slightly better than laminaria, in terms of the lower number of used devices to attain significant cervical ripening and faster induction-todelivery interval.…”

Section: Interpretation Of Findings and Clinical Implicationsmentioning

confidence: 99%

“…8 Among the mechanical methods, cervical osmotic dilators are commonly used. 8,9 They exist in natural (laminaria) and synthetic (dilapan, dilapan-S, and lamicel) forms. 8,9 They functionally absorb the fluids within the cervix by means of osmosis, steadily distend the amniochorionic membranes and myometrial cells, and gradually stimulate the release of prostaglandins.…”

mentioning

confidence: 99%

“…8,9 One key advantage of the cervical osmotic dilators is the lack of drug-related side effects. 9 On the other hand, among the pharmacological methods, prostaglandin E2 analogues-such as dinoprostone-are commonly used with a largely high success rate. 8,9 They functionally stimulate myometrial contraction and induce progesterone withdrawal.…”

mentioning

confidence: 99%

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Cervical Osmotic Dilators versus Dinoprostone for Cervical Ripening during Labor Induction: A Systematic Review and Meta-analysis of 14 Controlled Trials

et al. 2023

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Objective This study aimed to conduct a systematic review and meta-analysis of all randomized and nonrandomized controlled trials (RCTs and NCTs, respectively) that explored the maternal–neonatal outcomes of cervical osmotic dilators versus dinoprostone in promoting cervical ripening during labor induction. Study Design Six major databases were screened until August 27, 2022. The quality of included studies was evaluated. The data were summarized as mean difference or risk ratio (RR) with 95% confidence interval (CI) in a random-effects model. Results Overall, 14 studies with 15 arms were analyzed (n = 2,380 patients). Ten and four studies were RCTs and NCTs, respectively. The overall quality for RCTs varied (low risk n = 2, unclear risk n = 7, and high risk n = 1), whereas all NCTs had good quality (n = 4). For the primary endpoints, there was no significant difference between both groups regarding the rate of normal vaginal delivery (RR = 1.04, 95% CI: 0.95–1.14, p = 0.41) and rate of cesarean delivery (RR = 1.04, 95% CI: 0.93–1.17, p = 0.51). Additionally, there was no significant difference between both groups regarding the mean change in Bishop score and mean time from intervention to delivery. The rate of uterine hyperstimulation was significantly lower in the cervical osmotic dilator group. For the neonatal outcomes, during cervical ripening, the rate of fetal distress was significantly lower in the cervical osmotic dilator group. There was no significant difference between both groups regarding the mean Apgar scores, rate of meconium-stained amniotic fluid, rate of umbilical cord metabolic acidosis, rate of neonatal infection, and rate of neonatal intensive care unit admission. Conclusion During labor induction, cervical ripening with cervical osmotic dilators and dinoprostone had comparable maternal–neonatal outcomes. Cervical osmotic dilators had low risk of uterine hyperstimulation compared with dinoprostone. Overall, cervical osmotic dilators might be more preferred over dinoprostone in view of their analogous cervical ripening effects, comparable maternal–neonatal outcomes, and lack of drug-related adverse events. Key Points

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Section: Interpretation Of Findings and Clinical Implicationsmentioning

confidence: 99%

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confidence: 99%

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Cervical Osmotic Dilators versus Dinoprostone for Cervical Ripening during Labor Induction: A Systematic Review and Meta-analysis of 14 Controlled Trials

et al. 2023

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“…As such, the choice of CRA may come down to preference, staff burden, ease of use, and cost. In regards to staff workload, cervical ripening with prostaglandins necessitates extended fetal and maternal monitoring during IOL due to the risk of uterine hyperstimulation, a risk that is reported by National Institute of Health and Clinical Excellence (NICE) to be reduced with mechanical methods [11][12][13]. In addition, differences in the need for analgesics or required re-administrations of the CRA can also impact resource use and staff workload [14].…”

Section: Introductionmentioning

confidence: 99%

Synthetic osmotic dilators (Dilapan-S) or dinoprostone vaginal inserts (Propess) for inpatient induction of labour: A UK cost-consequence model

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Zaher

Torres

et al. 2022

European Journal of Obstetrics & Gynecology and Reproductiv

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“…Однако простагландины противопо казаны при бронхиальной астме, а также у женщин, пере несших операции на матке, а мифепристон не рекомен дован при длительном приеме глюкокортикоидов, нару шениях свертывания крови, на фоне лечения антикоагу лянтами [12,13]. Механические методы противопоказаны при наличии инфекции в родовых путях [14]. Несмотря на меньшее, по сравнению с фармакологическими мето дами, количество противопоказаний, механические мето ды проигрывают в комфортности для пациенток и требу ют специальных условий применения.…”

Section: Introductionunclassified

The use of a vaginal therapeutic system with prostaglandin for induction of labor

et al. 2022

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Introduction. Induction of labor is one of the most frequent procedures in modern obstetrics, which reduces the frequency of cesarean section and improves pregnancy outcomes. However, the effectiveness and safety of labor induction methods vary. Currently, the vaginal therapeutic system (SVT) with dinoprostone is certified for use for childbirth in Russia. Aim. To conduct a review of the literature data and a pilot study of the effectiveness and safety of the vaginal therapeutic system with dinoprostone for induction of labor. Materials and methods. A review of the literature for 2001–2022 devoted to the use of vaginal systems with gradual release of prostaglandin for induction of labor was conducted. Additionally, a prospective observational study of the effectiveness and safety of the dinoprostone system was conducted in 18 pregnant women. The evaluation criteria were: the frequency of labor, the degree of maturation of the cervix on the Bishop scale, as well as the frequency of vaginal delivery. Results. Literature data indicate that SVT with dinoprostone has comparable efficacy with other methods of pre-induction / induction of labor. The system with dinoprostone has a lower frequency of the side effect of “tachysystole” than the system with misoprostol. Compared with mechanical methods, SVT is assotiated with a lower frequency of oxytocin use. The use of SVT with dinoprostone showed an efficiency of 77.8% (in terms of the of labor start or cervical ripening). No side effects requiring termination of labor induction were registered in our study. Conclusions. Thus, vaginal insertion with prostaglandin E2 – dinoprostone is an effective and safe method of pre-induction of labor. Taking into account the small sample size in our work, it is of interest to continue research in order to obtain more complete data and in comparison with other methods.

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Mechanical methods for induction of labor

Cited by 10 publications

References 46 publications

Cervical Osmotic Dilators versus Dinoprostone for Cervical Ripening during Labor Induction: A Systematic Review and Meta-analysis of 14 Controlled Trials

Cervical Osmotic Dilators versus Dinoprostone for Cervical Ripening during Labor Induction: A Systematic Review and Meta-analysis of 14 Controlled Trials

Synthetic osmotic dilators (Dilapan-S) or dinoprostone vaginal inserts (Propess) for inpatient induction of labour: A UK cost-consequence model

The use of a vaginal therapeutic system with prostaglandin for induction of labor

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