International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2025
Comparison of the sequential use of mifepristone and dinoprostone vaginal insert with dinoprostone vaginal insert as the only method for induction of labor in very unripe cervix: a secondary analysis of a multicenter real-word evidence study.
СтатьяМногоцентровое исследованиеСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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Baev Oleg R, Babich Dmitry A, Tskhay Vitaly B, Bezhenar Vitaly F, Edilberg Irina V, Sukhikh Gennady T
Аннотация
OBJECTIVE: Induction of labor is a prevalent obstetric procedure designed to artificially initiate the labor process, which is critical for achieving vaginal delivery. A key factor influencing the success of induction of labor is cervical ripening, assessed using the Bishop score. A low Bishop score (0-3) indicates an unfavorable cervix and is associated with a higher risk of induction failure. This study aims to compare the efficacy of two approaches to labor induction: the sequential use of mifepristone followed by dinoprostone (two-step approach) versus dinoprostone alone (one-step approach) in women with a very low Bishop score.
METHODS: A secondary analysis was conducted on data from a multicenter clinical trial involving 503 women with non-urgent indications for induction of labor. Of these, 296 participants met the inclusion criteria and were analyzed.
RESULTS: The results demonstrated that pretreatment with mifepristone significantly improved labor outcomes. The vaginal delivery rate was 73.4% in the mifepristone group compared to 51.5% in the dinoprostone-only group (P < 0.001). Additionally, the interval from dinoprostone insertion to delivery was shorter in the mifepristone group, and the rate of failed induction was significantly lower (1.0% vs. 6.5%).
CONCLUSION: These findings suggest that the sequential use of mifepristone prior to dinoprostone administration enhances the likelihood of successful labor induction in women with a very low Bishop score. The study highlights the importance of optimizing cervical ripening methods to improve labor outcomes.
METHODS: A secondary analysis was conducted on data from a multicenter clinical trial involving 503 women with non-urgent indications for induction of labor. Of these, 296 participants met the inclusion criteria and were analyzed.
RESULTS: The results demonstrated that pretreatment with mifepristone significantly improved labor outcomes. The vaginal delivery rate was 73.4% in the mifepristone group compared to 51.5% in the dinoprostone-only group (P < 0.001). Additionally, the interval from dinoprostone insertion to delivery was shorter in the mifepristone group, and the rate of failed induction was significantly lower (1.0% vs. 6.5%).
CONCLUSION: These findings suggest that the sequential use of mifepristone prior to dinoprostone administration enhances the likelihood of successful labor induction in women with a very low Bishop score. The study highlights the importance of optimizing cervical ripening methods to improve labor outcomes.