Dinoprostone pessary for labor induction in Chinese patients with premature rupture of membranes at term: A retrospective cohort.

AIM: Whether the use of dinoprostone pessary increased the vaginal delivery rate of labor induction in Chinese nulliparous women with term premature rupture of membranes (PROM) and unfavorable cervices?

METHODS

PROM women at term with singleton pregnancies and Bishop scores ≤4 who needed labor induction were enrolled in this retrospective study. They received either the dinoprostone pessary followed by oxytocin infusion if necessary (n = 102, PGE2 group) or oxytocin infusion alone (n = 103, oxytocin group).

RESULTS

Compared with oxytocin infusion alone, vaginal delivery within 12 h and total vaginal delivery were higher in the PGE2 group (28.4% vs 7.8%, p = 0.0001; 79.4% vs 62.1%, p = 0.009, respectively). There were no statistical differences between the two groups in terms of maternal and neonatal outcomes, such as postpartum hemorrhage, endometritis, third- and fourth-degree vaginal lacerations and neonatal weight, 1- and 5-min Apgar score ≤7, neonatal jaundice, and neonatal unit admission (p > 0.05). However, there was a higher rate of uterine hyperstimulation in the PGE2 group (20.6% vs 3.9%, p < 0.0001). The effective rate of cervical ripening increased in the PGE2 group at 8 and 12 h of labor induction (p < 0.001).

CONCLUSIONS

Despite higher rates of uterine hyperstimulation, the use of dinoprostone was associated with higher rates of vaginal deliveries in Chinese nulliparous women with term PROM and Bishop scores ≤4, compared with use of oxytocin only.