title: Oxytocin versus sustained-release dinoprostone vaginal pessary for labor induction of unfavorable cervix with Bishop score ≥ 4 and ≤ 6: a randomized controlled trial.
abstract: OBJECTIVE
  To compare the efficacy and safety of high-dose intravenous oxytocin and sustained-release dinoprostone vaginal pessaries for cervical ripening and labor induction in pregnant patients at term with poor Bishop scores.
  
  
  METHODS
  Women at term with a Bishop score ≥ 4 and ≤ 6 were randomized into two groups to undergo induction of labor with either high-dose oxytocin administered intravenously (n = 90) or dinoprostone-only vaginal pessary without oxytocin augmentation (n = 90). The main outcome measures were rate of cesarean delivery, induction to delivery interval, number of deliveries achieved within 4, 8, 12, and 16 h of labor induction, maternal complications during induction, fetal outcome, and total hospital stay. In this study, per-protocol analysis was performed.
  
  
  RESULTS
  There were fewer cesarean deliveries with oxytocin compared to dinoprostone-only groups (7/79 vs 14/89); however, the difference was not statistically significant. The induction-delivery intervals (7.9 h vs 12.0 h, P < 0.001; and 5.7 vs 10.4 h, P < 0.001; oxytocin vs dinoprostone-only for primiparous and multiparous patients, respectively) were significantly shorter in oxytocin-induced patients compared to dinoprostone-only. A significantly higher percentage of patients delivered in the oxytocin group compared to the dinoprostone-only group in 4, 8, 12, 16, and 20 h.
  
  
  CONCLUSIONS
  Intravenous oxytocin is effective to stimulate labor at term for patients with Bishop scores ≥ 4 and ≤ 6, with a shorter time interval from induction to vaginal delivery.
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Abant İzzet Baysal University, Bolu, Turkey. onderkoc1@hotmail.com
authors.forename: Onder
authors.initials: O
authors.lastname: Koc
authors.forename: Bülent
authors.initials: B
authors.lastname: Duran
authors.forename: Safak
authors.initials: S
authors.lastname: Ozdemirci
authors.forename: Mustafa
authors.initials: M
authors.lastname: Albayrak
authors.forename: Ummugulsum
authors.initials: U
authors.lastname: Koc
mesh_terms: D000328:Adult; D020070:Cervical Ripening; D003692:Delayed-Action Preparations / Q000008:administration & dosage / Q000009:adverse effects; D015232:Dinoprostone / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D007751:Labor, Induced / Q000009:adverse effects; D010120:Oxytocics / Q000008:administration & dosage* / Q000009:adverse effects; D010121:Oxytocin / Q000008:administration & dosage* / Q000009:adverse effects; D010570:Pessaries; D011247:Pregnancy; D013997:Time Factors; D055815:Young Adult
chemical_list: D003692:Delayed-Action Preparations; D010120:Oxytocics; D010121:Oxytocin; D015232:Dinoprostone