title: Obesity and cervical ripening failure risk.
abstract: OBJECTIVE
  To estimate the impact of obesity on cervical ripening with prostaglandin E2 (PGE2).
  
  
  METHODS
  A retrospective study compared the cervical ripening efficiency of PGE2 on patients with BMI above 30 kg/m(2) and normal weight patients with BMI between 20 kg/m(2) and 25 kg/m(2). In case of a Bishop score (≤3), a dinoprostone tampon was used over 12 h. In case of a Bishop score (4;6), a dinoprostone gel was used over 6 h. Failure of first cervical ripening attempt was defined, as the persistence of a Bishop score <6, 12 h after dinoprostone tampon or 6 h after dinoprostone gel.
  
  
  RESULTS
  Ninety-five obese patients were matched according to parity to 190 non-obese patients. The failure rate of the first attempt at cervical ripening was significantly higher (P = 0.0016) among obese patients (53.7%) as compared to patients with a BMI in between 20 and 25 (34.2%). After multivariate analysis BMI ≥ 30 (OR = 2.32 (1.47-4.00), P = 0.0019), parity ≤2 (OR = 2.50 (1.20-5.26) P = 0.0137), and the Bishop score ≤3 (OR = 2.62 (1.45-4.72), P = 0.0014) were significantly and independently associated to prostaglandin ripening failure.
  
  
  CONCLUSIONS
  Obesity seems to be associated to lower E2 prostaglandin sensitivity.
authors.affiliation: Department of Gynaecology and obstetrics, Hospital Mère Enfant, CHU Dupuytren, av Larrey 87000 Limoges, France. gauthiertristan@yahoo.fr
authors.forename: Tristan
authors.initials: T
authors.lastname: Gauthier
authors.forename: Sophie
authors.initials: S
authors.lastname: Mazeau
authors.forename: François
authors.initials: F
authors.lastname: Dalmay
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Eyraud
authors.forename: Cyril
authors.initials: C
authors.lastname: Catalan
authors.forename: Benoit
authors.initials: B
authors.lastname: Marin
authors.forename: Yves
authors.initials: Y
authors.lastname: Aubard
mesh_terms: D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D020070:Cervical Ripening; D002584:Cervix Uteri / Q000187:drug effects*; D015331:Cohort Studies; D015232:Dinoprostone / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007751:Labor, Induced / Q000379:methods*; D016015:Logistic Models; D009765:Obesity / Q000150:complications*; D010120:Oxytocics / Q000494:pharmacology / Q000627:therapeutic use*; D011247:Pregnancy; D011248:Pregnancy Complications; D012189:Retrospective Studies; D017211:Treatment Failure; D055815:Young Adult
chemical_list: D010120:Oxytocics; D015232:Dinoprostone