Labor induction in term premature rupture of membranes: comparison between oxytocin and dinoprostone followed 6 hours later by oxytocin

• Published in: American journal of obstetrics and gynecology 2012, Vol.206 (1), p.60.e1-60.e8
• Main Authors: Güngördük, Kemal, MD, Asicioglu, Osman, MD, Besimoglu, Berhan, MD, Güngördük, Ozgu Celikkol, MD, Yildirm, Gokhan, MD, Ark, Cemal, MD, Şahbaz, Ahmet, MD
• Format: Article
• Language: English
• Subjects: Adult; Biological and medical sciences; Delivery. Postpartum. Lactation; dinoprostone; Dinoprostone - administration & dosage; Diseases of mother, fetus and pregnancy; Disorders; Female; Fetal Membranes, Premature Rupture - physiopathology; Gynecology. Andrology. Obstetrics; Humans; induction of labor; Labor, Induced - methods; Medical sciences; Obstetrics and Gynecology; Oxytocics - administration & dosage; oxytocin; Oxytocin - administration & dosage; Pregnancy; Pregnancy Outcome; Pregnancy. Fetus. Placenta; premature rupture of membranes; Young Adult
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/j.ajog.2011.07.035

Objective The aim of this randomized study was to compare 2 protocols for inducing labor in women with premature rupture of membranes (PROM) at term. Study Design Women with PROM and a Bishop score ≤5 were randomly assigned to receive either an intravenous oxytocin infusion (n = 223) or a dinoprostone pessary followed 6 hours later by an intravenous oxytocin infusion (n = 227). Results Vaginal delivery within 24 hours of labor induction increased significantly with sustained-released dinoprostone followed by oxytocin infusion (78.5% vs 63.3%; relative risk, 1.23; 95% confidence interval, 1.09–1.39; P = .001). Maternal and neonatal outcomes were similar between the groups. Conclusion Sustained-released dinoprostone followed 6 hours later by an oxytocin infusion in term women with PROM was associated with a higher rate of vaginal delivery within 24 hours, and no difference in maternal-neonatal complications was observed compared with oxytocin infusion alone.