Using dinoprostone slow release vaginal insert for cervical ripening in term‐pregnancy with oligohydramnios

Abstract

The study purposed to evaluate the success rate of cervical ripening using dinoprostone controlled-release vaginal insert and reveal some factors relating to successful cervical ripening. Methods: This cross-sectional study was conducted at Tu Du Hospital in Vietnam from December 2021 to August 2022. The study enrolled 200 pregnant women with gestational age ≥37 weeks diagnosed with oligohydramnios. These candidates underwent dinoprostone cervical ripening (DCR) according to the local protocol. The Bishop score ≥7 after 24 h was determined for the successful cervical ripening (SCR). Results: In total, the success rate of DCR achieved at 57.5% and the cesarean delivery rate was 46.5%. None of the severe side-effects and complications was present. Using multivariable logistic regression, the study found that the body mass index ≥25 kg/m 2 and oxytocin infusion drip related to SCR with adjusted odds ratio (aOR): 3.67 (95% confidence intervals [CI]: 1.78-7.57) and aOR: 4.68 (95% CI: 1.84-11.93), p < 0.001. Using the Kaplan-Meier curve, the present study revealed a significant difference between Bishop <3 and ≥3 following the duration time of cervical ripening, with hazard ratio: 1.38 (95% CI: 1.19-1.59), p < 0.001. The time duration of cervical ripening was not significantly different following amniotic fluid index from 3 to 5 cm. Conclusions: Cervical ripening using a dinoprostone vaginal insert is a potentially acceptable method in term pregnancy accompanying with oligohydramnios. The probability of SCR can be predicted on a careful assessment of relative factors by obstetricians. Further studies are required to strengthen these findings.

Motherhood Role from a Postpartum Perspective: Effects Reflected by High-Risk and Normal Pregnancies

“…Each item on the scale was scored as 1-2-3-4-5. Items 7,8,9,10,14,15,19,20,21,22,23,24, 25 on the scale were reverse-coded, meaning they were scored as 5-4-3-2-1. The maximum score obtainable from the scale was 130, and the minimum score was 26, with increasing scores indicating the gaining of the maternal role [13].…”

“…Among these conditions, the most common ones are pregnancy-induced hypertensive disorders (gestational hypertension and preeclampsia), gestational diabetes mellitus (GDM), and acute kidney injury (AKI). Additionally, conditions such as cervical changes, placental abruption, and kidney stones can also occur [6,9]. Moreover, the rising incidence of Placenta Accreta Spectrum due to high rates of cesarean sections is a significant concern for both pregnant women and obstetricians, especially in low-resource settings.…”