title: Induction of labor and pain: a randomized trial between two vaginal preparations of dinoprostone in nulliparous women with an unfavorable cervix.
abstract: OBJECTIVE
  To compare pain associated with vaginal dinoprostone pessary vs. gel for induction of labor in women with an unfavorable cervix.
  
  
  METHODS
  A randomized controlled trial in a large academic public general hospital. A total of 52 nulliparous women of gestational age ≥ 38 weeks, with Bishop score ≤ 4 and intact membranes were allocated either to a controlled-release vaginal dinoprostone pessary or repeat doses of vaginal dinoprostone gel. Pain was recorded hourly from early induction until the onset of labor.
  
  
  RESULTS
  Mean pain experienced by women belonging to the two groups differed significantly (p < 0.01). Women in the controlled-release device group were also significantly more often severe pain-free than women receiving gel (p < 0.05). Both methods had similar rates of oxytocin infusion and vaginal deliveries.
  
  
  CONCLUSIONS
  The two induction procedures should be considered equivalent as far as ripening the cervix and initiating labor. In view of this finding, the low Bishop score should be considered an indication to prefer the controlled-release device, since it reduces pain thereby improving the physical and emotional wellbeing of the parturient.
authors.affiliation: Department of Life Science and Reproduction, University of Verona, Verona, Italy. giovanni.zanconato@univr.it
authors.forename: Giovanni
authors.initials: G
authors.lastname: Zanconato
authors.forename: Valentino
authors.initials: V
authors.lastname: Bergamini
authors.forename: Elena
authors.initials: E
authors.lastname: Mantovani
authors.forename: Roberta
authors.initials: R
authors.lastname: Carlin
authors.forename: Oscar
authors.initials: O
authors.lastname: Bortolami
authors.forename: Massimo
authors.initials: M
authors.lastname: Franchi
mesh_terms: D000282:Administration, Intravaginal; D000328:Adult; D015232:Dinoprostone / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006801:Humans; D007751:Labor, Induced / Q000009:adverse effects* / Q000379:methods; D010120:Oxytocics / Q000008:administration & dosage* / Q000009:adverse effects; D010146:Pain / Q000188:drug therapy / Q000517:prevention & control*; D010570:Pessaries; D011247:Pregnancy; D016896:Treatment Outcome; D014622:Vaginal Creams, Foams, and Jellies
chemical_list: D010120:Oxytocics; D014622:Vaginal Creams, Foams, and Jellies; D015232:Dinoprostone