title: Impact of prolonged dinoprostone cervical ripening on the rate of artificial induction of labor: a prospective study of 330 patients.
abstract: OBJECTIVE
  The aim of this study was to evaluate two regimens of administration of sustained-release dinoprostone on the need for oxytocin induction of labor.
  
  
  METHODS
  We carried out an open prospective study comparing labor, maternal and neonatal outcomes after 12 h of prostaglandin cervical ripening insert versus 24 h of prostaglandin cervical ripening insert in 284 patients (142 ripenings at 12 h [P12 group] and 142 ripenings at 24 h [P24 group]).
  
  
  RESULTS
  The two groups were demographically similar. There was a significant difference in the need for artificial rupture of membranes/oxytocin induction of labor between the groups (49.3% for the P12 group vs 38% for the P24 group, P = 0.03). The delay between the beginning of ripening and delivery was significantly decreased in the P12 group, but the duration of active labor (6.6 h), the dose of oxytocics used (1326 UI), the rate of cesarean section, the rate of uterine hyperstimulation, the rates of hemorrhaging from delivery, the neonatal state and the experience of induction were similar in the two groups.
  
  
  CONCLUSIONS
  This study allows us to show for the first time that sustained-release of dinoprostone leads to spontaneous induction of labor without increasing the obstetrical risk in a majority of patients.
authors.affiliation: Obstetrics and Gynecology Service, University of Caen, Caen, France.
authors.forename: Christine
authors.initials: C
authors.lastname: Denoual-Ziad
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Aicardi-Nicolas
authors.forename: Christian
authors.initials: C
authors.lastname: Creveuil
authors.forename: Cathy
authors.initials: C
authors.lastname: Gaillard
authors.forename: Michel
authors.initials: M
authors.lastname: Dreyfus
authors.forename: Guillaume
authors.initials: G
authors.lastname: Benoist
mesh_terms: D000282:Administration, Intravaginal; D000328:Adult; D020070:Cervical Ripening; D002585:Cesarean Section; D003692:Delayed-Action Preparations; D015232:Dinoprostone / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007751:Labor, Induced; D010120:Oxytocics / Q000008:administration & dosage*; D010121:Oxytocin / Q000008:administration & dosage; D011247:Pregnancy; D011446:Prospective Studies; D013997:Time Factors; D055815:Young Adult
chemical_list: D003692:Delayed-Action Preparations; D010120:Oxytocics; D010121:Oxytocin; D015232:Dinoprostone
keywords: cervical ripening; dinoprostone; intra-vaginal administration; pregnancy; therapeutic use of; treatment outcome