[Factors predicting unsuccessful labor induction with dinoprostone in post-term pregnancy with unfavorable cervix].
OBJECTIVE
To identify predictive factors for unsuccessful induction of labor within 24hours after dinoprostone insertion in post-term pregnancy with unfavorable cervix.


METHODS
We retrospectively reviewed 325 singleton pregnancies with a diagnosis of post-term pregnancy and unfavorable cervix (Bishop score<6) during the period January 2012-Decembre 2012. Patients were classified into 2 groups: successful labor, defined as cervical ripening, within 24hours after dinoprostone insertion (Group R; n=248; 76.3 %) or failure group (Group E; n=77; 23.7 %). Antepartum and perpartum characteristics of women were compared.


RESULTS
Nulliparity (74.0 versus 56.0 %; OR=2.23; 95 % CI: 1.27-4.00; P=0.005), gestational age ≤41 SA+4 (53.2 versus 33.9 %; OR=2.22; 95 % CI: 1.32-3.74; P=0.003) and history of dilatation and curettage (27.3 versus 10.5 %; OR=3.19; 95 % CI: 1.66-6.11; P=0.0005) were significantly associated with unsuccessful induction of labor. Bishop score was significantly higher in Group R (3.6 versus 1.9; P=0.001). Also, consistency (74.0 versus 44.4 %; OR=3.57; 95 % CI: 2.04-6.40; P<10(-5)) and absence of dilatation of the cervix (59.7 versus 23.0 %; OR=4.97; 95 % CI: 2.89-8.56; P<10(-6)) were identified as significant predictive factors for unsuccessful induction of labor.


CONCLUSIONS
Nulliparity, gestational age ≤41 SA+4, history of dilatation and curettage and Bishop score, in particular consistency and dilatation, are correlated with failure of cervical ripening in post-term pregnancy with unfavorable cervix.
Service de gynécologie-obstétrique, centre hospitalier départemental Vendée, 85000 La Roche-sur-Yon, France. Electronic address: g.ducarme@gmail.com.
G
G
Ducarme
Service d'information médicale, centre hospitalier départemental Vendée, 85000 La Roche-sur-Yon, France.
V
V
Chesnoy
Service de gynécologie-obstétrique, centre hospitalier départemental Vendée, 85000 La Roche-sur-Yon, France.
L
L
Petit
D000328:Adult; D020070:Cervical Ripening / Q000187:drug effects / Q000502:physiology; D002584:Cervix Uteri / Q000473:pathology* / Q000503:physiopathology; D015232:Dinoprostone / Q000627:therapeutic use*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007751:Labor, Induced / Q000379:methods*; D008875:Middle Aged; D010120:Oxytocics / Q000627:therapeutic use*; D010298:Parity; D011247:Pregnancy; D011273:Pregnancy, Prolonged / Q000175:diagnosis* / Q000188:drug therapy* / Q000473:pathology; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D017211:Treatment Failure; D055815:Young Adult
D010120:Oxytocics; D015232:Dinoprostone
Bishop score; Cervical ripening; Grossesse prolongée; Maturation cervicale; Post-term pregnancy; Score de Bishop