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Oxytocin versus sustained-release dinoprostone vaginal pessary for labor induction of unfavorable cervix with Bishop score ≥ 4 and ≤ 6: a randomized controlled trial



Oxytocin versus sustained-release dinoprostone vaginal pessary for labor induction of unfavorable cervix with Bishop score ≥ 4 and ≤ 6: a randomized controlled trial



Journal of Obstetrics and Gynaecology Research 39(4): 790-798



To compare the efficacy and safety of high-dose intravenous oxytocin and sustained-release dinoprostone vaginal pessaries for cervical ripening and labor induction in pregnant patients at term with poor Bishop scores. Women at term with a Bishop score ≥ 4 and ≤ 6 were randomized into two groups to undergo induction of labor with either high-dose oxytocin administered intravenously (n = 90) or dinoprostone-only vaginal pessary without oxytocin augmentation (n = 90). The main outcome measures were rate of cesarean delivery, induction to delivery interval, number of deliveries achieved within 4, 8, 12, and 16 h of labor induction, maternal complications during induction, fetal outcome, and total hospital stay. In this study, per-protocol analysis was performed. There were fewer cesarean deliveries with oxytocin compared to dinoprostone-only groups (7/79 vs 14/89); however, the difference was not statistically significant. The induction-delivery intervals (7.9 h vs 12.0 h, P < 0.001; and 5.7 vs 10.4 h, P < 0.001; oxytocin vs dinoprostone-only for primiparous and multiparous patients, respectively) were significantly shorter in oxytocin-induced patients compared to dinoprostone-only. A significantly higher percentage of patients delivered in the oxytocin group compared to the dinoprostone-only group in 4, 8, 12, 16, and 20 h. Intravenous oxytocin is effective to stimulate labor at term for patients with Bishop scores ≥ 4 and ≤ 6, with a shorter time interval from induction to vaginal delivery.

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Accession: 036657002

Download citation: RISBibTeXText

PMID: 23167718

DOI: 10.1111/j.1447-0756.2012.02045.x


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