A Randomized Controlled Trial of Extra-amniotic Saline Infusion vs Intracervical Dinoprostone Gel for Induction of Labor

Abstract

ABSTRACT Background Success of induction depends largely on cervical ripening and increases the likelihood of vaginal delivery. This study compared the outcomes for induction of labor using extra-amniotic saline infusion (EASI) vs intracervical dinoprostone gel. Objective: Primary: To compare improvement between pre- and post-induction Bishop’s scores in both the groups. Secondary: To compare induction to delivery interval, mode of delivery, and neonatal outcome in both the groups. Materials and methods A randomized controlled trial of 1 year was conducted in the Department of Obstetrics and Gynaecology, Karnataka Lingayat Education University Dr Prabhakar Kore Hospital and Medical Research Centre, Belagavi, Karnataka, India, on 82 pregnant women from January 2014 to December 2014. The selected women were divided into two groups of 41 each as group I (induced with dinoprostone) and group II (induced with EASI using Foley’s catheter). Results Significantly higher number of women had postinduction Bishop’s scores between 9 and 12 in the dinoprostone group (70.73%; p < 0.001). The mean Bishop’s scores were significantly high in the dinoprostone gel (9.27 ± 3.07) vs EASI (8.22 ± 2.34; p = 0.086). Cervical ripening based on cut-off score of ≥6 was noted in a significantly higher number of women (92.68%) in EASI (p = 0.241). The mean time for cervical ripening was significantly high in dinoprostone gel group compared with EASI (15.44 ± 8.41 vs 3.88 ± 3.67; p < 0.001), but mean induction to delivery time was comparable (p = 0.086). Significantly higher numbers of vaginal deliveries were noted in dinoprostone group (91.43%; p = 0.001). The neonatal outcomes, i.e., birth weight, mean birth weight, appearance, pulse, grimace, activity, and respiration score at 1 and 5 minutes, and neonatal intensive care unit admission, were comparable (p = 0.570). Conclusion Dinoprostone gel and EASI using Foley’s catheter appear to be effective methods for cervical ripening and labor induction, but dinoprostone gel yielded significantly higher rate of vaginal delivery. How to cite this article Rodrigues SV, Swamy MK, Jadhav N. A Randomized Controlled Trial of Extra-amniotic Saline Infusion vs Intracervical Dinoprostone Gel for Induction of Labor. Int J Gynecol Endsc 2017;1(1):11-17