title: [Cervical ripening after previous cesarean section with dinoprostone vaginal insert].
abstract: OBJECTIVE
  Because, to date in France, 20 % of pregnant women had a scared uterus and because the best mean of cervical ripening is unknown and controversial, we want to evaluate efficacy and safety of dinoprostone for cervical ripening in women with previous cesarean.
  
  
  METHODS
  We conducted a retrospective unicentric study, from 2010 to 2014, at Limoges regional university hospitals. Two hundred and sixty nine patients, with medical indication for induction of labor and scared uterus, were included and ripened with dinoprostone (Propess®and/or Prostine®). Women had unfavorable cervix with Bishop score inferior to 6.
  
  
  RESULTS
  Overall rate of vaginal delivery was 62 %. Patients have had more of one prostaglandin in 19 % of cases; the cesarean rate was significantly higher in this case (cesarean: 55.6 % vs. vaginal delivery: 44.4 %; P=0.0043). Overall, there were respectively 4 % and 0.7 % of post-partum hemorrhage and uterine rupture. One percent of newborns had a severe acidosis (pH<7 in umbilical artery) and 1 % was admitted to the Intensive Neonatal Care Unit.
  
  
  CONCLUSIONS
  Dinoprostone is an effective procedure in patients with previous cesarean section requiring labor induction, with a morbidity comparable to other methods of induction of labor.
authors.affiliation: Service de gynécologie obstétrique, hôpital Mère-Enfant, CHU de Limoges, 8, avenue Dominique-Larrey, 87000 Limoges, France. Electronic address: perrinemazeau@yahoo.fr.
authors.forename: P
authors.initials: P
authors.lastname: Coste Mazeau
authors.affiliation: Service de gynécologie obstétrique, hôpital Mère-Enfant, CHU de Limoges, 8, avenue Dominique-Larrey, 87000 Limoges, France.
authors.forename: C
authors.initials: C
authors.lastname: Catalan
authors.affiliation: Service de gynécologie obstétrique, hôpital Mère-Enfant, CHU de Limoges, 8, avenue Dominique-Larrey, 87000 Limoges, France.
authors.forename: J-L
authors.initials: JL
authors.lastname: Eyraud
authors.affiliation: Service de gynécologie obstétrique, hôpital Mère-Enfant, CHU de Limoges, 8, avenue Dominique-Larrey, 87000 Limoges, France.
authors.forename: Y
authors.initials: Y
authors.lastname: Aubard
authors.affiliation: Service de gynécologie obstétrique, hôpital Mère-Enfant, CHU de Limoges, 8, avenue Dominique-Larrey, 87000 Limoges, France.
authors.forename: T
authors.initials: T
authors.lastname: Gauthier
mesh_terms: D000282:Administration, Intravaginal; D020070:Cervical Ripening / Q000187:drug effects* / Q000502:physiology*; D002585:Cesarean Section / Q000009:adverse effects; D002921:Cicatrix / Q000150:complications; D015232:Dinoprostone / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D005602:France; D006801:Humans; D007751:Labor, Induced / Q000379:methods; D010120:Oxytocics; D006473:Postpartum Hemorrhage / Q000453:epidemiology; D011247:Pregnancy; D012189:Retrospective Studies; D014597:Uterine Rupture / Q000453:epidemiology; D014599:Uterus; D016064:Vaginal Birth after Cesarean / Q000706:statistics & numerical data
chemical_list: D010120:Oxytocics; D015232:Dinoprostone
keywords: Cervical ripening; Déclenchement artificiel; Labor induction; Maturation cervicale; Previous cesarean section; Prostaglandines; Prostaglandins; Utérus cicatriciel