title: Home cervical ripening with dinoprostone gel in nulliparous women with singleton pregnancies.
abstract: OBJECTIVE
  To evaluate whether home cervical ripening is safe and results in shorter hospital stay.
  
  
  METHODS
  This was a retrospective cohort study of women with singleton pregnancies having induction of labor for postmaturity at a single center between January 2007 and June 2010. Women were offered home cervical ripening with 1 mg dinoprostone gel if they were nulliparous, had uncomplicated singleton pregnancies, and the indication for induction was postmaturity.
  
  
  RESULTS
  Nine hundred seven of 1,536 (59.1%) nulliparous women having induction of labor for postmaturity were eligible for home cervical ripening. The median number of hours at home was 11.76 hours (range 0-24.82 hours). There were no cases of birth outside of the hospital, uterine rupture, or significant neonatal morbidity or neonatal death related to home cervical ripening. Eighty-five (5.5%) women who underwent hospital cervical ripening because of maternal preference or social issues formed a hospital cervical ripening comparison group. There was no significant difference in the total number of hours before delivery spent in the hospital between the two groups (26.25; 95% confidence interval [CI] 25.27-27.23 in home cervical ripening group compared with 24.28; 95% CI 22.5-26.0 in the hospital group; P=.26).
  
  
  CONCLUSIONS
  Clinical outcomes are comparable in nulliparous women who receive a single dose of dinoprostone gel for home cervical ripening compared with those who undergo hospital cervical ripening. However, preadmission home cervical ripening with 1 mg dinoprostone does not decrease the number of hours women spend in the hospital.
  
  
  METHODS
  II.
authors.affiliation: Tommy's Centre for Maternal and Fetal Health and MRC Centre for Reproductive Health, University of Edinburgh, Queen's Medical Research Institute, and the Departments of Obstetrics and Gynaecology and Neonatology, Simpson Centre for Reproductive Health, Edinburgh Royal Infirmary, Edinburgh, United Kingdom.
authors.forename: Sarah J
authors.initials: SJ
authors.lastname: Stock
authors.forename: Rebecca
authors.initials: R
authors.lastname: Taylor
authors.forename: Rebecca
authors.initials: R
authors.lastname: Mairs
authors.forename: Abdulhamid
authors.initials: A
authors.lastname: Azaghdani
authors.forename: Kahyee
authors.initials: K
authors.lastname: Hor
authors.forename: Imogen
authors.initials: I
authors.lastname: Smith
authors.forename: Kirsty
authors.initials: K
authors.lastname: Dundas
authors.forename: Chris
authors.initials: C
authors.lastname: Kissack
authors.forename: Jane E
authors.initials: JE
authors.lastname: Norman
authors.forename: Fiona
authors.initials: F
authors.lastname: Denison
mesh_terms: D000328:Adult; D020070:Cervical Ripening; D015232:Dinoprostone / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D005782:Gels; D006801:Humans; D007902:Length of Stay; D010120:Oxytocics / Q000009:adverse effects / Q000627:therapeutic use*; D010298:Parity; D011247:Pregnancy; D012189:Retrospective Studies; D012646:Self Administration / Q000009:adverse effects; D013997:Time Factors
chemical_list: D005782:Gels; D010120:Oxytocics; D015232:Dinoprostone