Daykan Yair, Biron-Shental Tal, Navve Daniella, Miller Netanella, Bustan Mor, Sukenik-Halevy Rivka
Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel.
Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
J Obstet Gynaecol Res. 2018 Sep;44(9):1739-1746. doi: 10.1111/jog.13715. Epub 2018 Jul 6.
To evaluate factors predictive of the success of dinoprostone slow release vaginal insert for cervical ripening.
A total of 169 women who underwent cervical ripening with dinoprostone slow release vaginal insert were included in the study cohort. The correlation between parameters present before cervical ripening with dinoprostone slow release and its success, as well as complications and adverse outcomes were analyzed.
Dinoprostone slow release vaginal insert was successful in achieving vaginal delivery in 148 of 169 (87.6%), while sufficient ripening was achieved in 140 (83%) cases. Factors associated with successful vaginal delivery were multiparity and younger gestational age at delivery. Factors predictive of the success of cervical ripening with dinoprostone slow release vaginal insert were lower body mass index (BMI), higher parity and perceived contractions prior to insertion. Intrauterine growth restriction was associated with a significant risk for dinoprostone insert removal. Neonatal outcomes were similar in cases of successful or failed ripening.
The success of cervical ripening with dinoprostone slow release vaginal insert can be predicted by factors that can be recognized at admission.
评估地诺前列酮缓释阴道栓剂用于促宫颈成熟成功的预测因素。
169例接受地诺前列酮缓释阴道栓剂促宫颈成熟的女性纳入研究队列。分析在使用地诺前列酮缓释进行促宫颈成熟前的各项参数与其成功率、并发症及不良结局之间的相关性。
169例中有148例（87.6%）使用地诺前列酮缓释阴道栓剂成功实现阴道分娩，140例（83%）实现了充分成熟。与成功阴道分娩相关的因素为经产和分娩时较年轻的孕周。预测地诺前列酮缓释阴道栓剂促宫颈成熟成功的因素为较低的体重指数（BMI）、较高的产次和放置前感觉到宫缩。宫内生长受限与取出地诺前列酮栓剂的显著风险相关。成熟成功或失败的病例中新生儿结局相似。
入院时可识别的因素能够预测地诺前列酮缓释阴道栓剂促宫颈成熟的成功。
