Experience of dinoprostone vaginal insert using for cervical ripening and induction of labor

Abstract

Introduction. Presently, preinduction and induction of labour is one of the approaches to improve maternal and perinatal outcomes. In this regard, the rate of labour induction is steadily increasing.Aim. To determine the efficacy and safety of dinoprostone vaginal insert for cervical ripening and labor induction.Materials and methods. The study included 81 women with a singleton pregnancy of 37 weeks. and more, cephalic presentation of the fetus, with the birth canal not ready and the presence of indications for induction of labor. Dinoprostone vaginal insert was placed for 24 hours or till onset of labor. After removal of the dinoprostone vaginal insert patient was undergoing cervical assessment by digital Bishop Score immediately. If labor didn’t start spontaneously, additional cervical ripening procedures may be considered or labor induction.Result. The Bishop score increased on average by 2 points after cervical ripening with dinoprostone vaginal insert. 77.78% of patients went into labor before dinoprostone vaginal insert removing. 71.6% of the women had the vaginal birth. The cesarean section rate was 29.6%. Failed labor induction was observed in 2.47% cases. All the children were born alive. The average weight of newborns corresponded to the general population. No infectious complications or significant side effects were recorded in the study.Conclusion. The use of dinoprostone vaginal insert is an effective method for cervical ripening (increase in Bishop score by an average of 2 points, p < 0.05) and labor induction (onset of labor before removal of SVT in 78% of cases) with a good safety profile (there were no serious adverse or side effects).