A Study to Compare the Fetomaternal Outcomes of Dinoprostone Gel Administration for Induction of Labor Across Posterior Fornix versus Intracervical Routes
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Abstract
Objectives: Although Dinoprostone (synthetic prostaglandin) gel as a cervical ripening agent for induction of labour has been extensively studied but there has been a paucity in the current literature, employing its use through the intracervical and posterior routes, especially in the Indian setting. The authors aimed to study and compare the fetomaternal outcomes with the use of 0.5 mg dinoprostone gel for induction of labour across intracervical and posterior fornix routes.
Materials and Methods: An observational study was conducted at a tertiary care hospital in Western India. Pregnant women presenting in the Obstetrics and Gynecology department of the institute were recruited in the study (n = 120). They were allowed to choose between the two groups, posterior fornix (PF; n = 60) and intracervical (IC; n = 60) after taking a valid written and inform consent. Primary outcomes were to measure the rates of normal vaginal delivery. Secondary outcomes that were studied included induction-to-delivery interval, rates of operative vaginal deliveries/ need for emergency caesarean section and incidence of maternal complications and adverse fetal outcomes were compared along the two routes of dinoprostone administration.
Results: Both the groups were homogenous in terms of maternal age, gestational age, or other maternal characteristics. Induction of labor was successful to result in a normal vaginal delivery in 45 and 42 women respectively in IC and PF groups. Participants undergoing emergency cesarean deliveries were 15 in IC and 18 in PF groups, respectively (differences not statistically significant).
Conclusion: Our study revealed that either of the routes can be successfully utilized for induction of labour with equal probability of successful vaginal delivery. Dinoprostone gel being relatively cheaper and more widely available can still serve as a potential cervical ripening agent.
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