Study of Inﬂuence of Vaginal Ph on the eﬃcacy of Dinoprostone gel for Induction of Labor
Efficacy of Dinoprostone gel for Induction of Labor
Background: Inducing labor is a procedure intended to trigger artificial contractions of the uterus that generally involve progressive erasure and dilation of the cervix. This will hopefully lead to the birth of a baby through the vaginal route. To assess the efficacy of dinoprostone gel in cervical maturation and its effect on vaginal pH. Subjects and Methods: The participants were grouped by their vaginal pH into two groups. Group, I included patients with vaginal pH 4.5 and Group II included vaginal pH >4.5 and the differences between the groups with respect to maternal age, parity, gestational age. Those women with minimal change in Bishop Score, received up to 3 doses of dinoprostone gel intracervically, 6 hours apart. Women, who had no change in Bishop Score at the end of induction with 3 doses of dinoprostone, were further reassessed. Results: There was no statistically pertinent relationship between the two groups in regard to maternal age, gestational age, parity, and initial Bishop Score. The mean maternal age in Group I was 25.9 years and Group II was 26.9 years. The mean gestational age was 39.5 weeks in group I and 38.9 weeks in group II. The majority of subjects were primigravidas (70 percent in group I and 63 percent in group II). The mean Bishop score before labor induction was 3.6 0.9 in Group I and 4 1.0 in Group II. Out of 200 cases, 33 (23.3 percent) needed an improvement in Oxytocin, 33 (33.3 percent) in Group I and 4 (13.3 percent) in Group II. The vaginal delivery rate was 90% in Group I and 87% in Group II. The Caesarean section was marginally higher in Group II (10 percent) compared with Group I (13 percent). Conclusion: Parity has a major impact on the pre-induction of the Bishop Score and the pH itself has a vaginal influence. Knowing the pre-induction vaginal pH may also be a helpful method for determining the outcome of PGE2 induction.
2. Ramsey PS, Ogburn PL, Harris DY, Heise RH, Ramin KD. Effect of vaginal pH on efficacy of the dinoprostone gel for cervical ripening/labor induction. Am J Obstet Gynecol. 2002;187(4):843–846. Available from: https://dx.doi.org/10. 1067/mob.2002.126987.
3. Das SCA, Kar M. A Review on Novelty and Potentiality of Vaginal Drug Delivery. Int J Pharmtech Res. 2011;3(2):1033– 1077.
4. Basirat Z, Barat SH, Ghanbarpour A, Golsorkhtabaramiri
M. Does vaginal pH affect the efficacy of dinoprostone in cervical ripening/labor duration? Clin Exp Obstetric Gynecol. 2012;39(4):522–527.
5. Sanchez-Ramos L, Gaudier FL, Kaunitz AM. Cervical Ripen- ing and Labor Induction After Previous Cesarean Delivery. Clin Obstet Gynecol. 2000;43(3):513–523. Available from: https://dx.doi.org/10.1097/00003081-200009000-00011.
6. Hofmeyr GJ, Gulmezoglu AM. Vaginal misoprostol for cervical ripening and induction of labour. Cochrane Database Syst Rev. 2002;2:941–941. Available from: https://doi.org/10. 1002/14651858.cd000941.
7. Sanchez-Ramos L, Kaunitz AM. Misoprostol for Cervical Ripening and Labor Induction: A Systematic Review of the Literature. Clin Obstet Gynecol. 2000;43(3):475–488. Avail- able from: https://dx.doi.org/10.1097/00003081-200009000- 00008.
8. Goswami J, Choudhury SS, Deka G. Effect of vaginal pH in cervical ripening with dinoprostone gel. New Indian j OBGYN. 2015;2(1):32–36.
9. Fi O, Ozakflit G, Yilmaz B. The Role of Vaginal pH on Efficacy of Controlled-Release Dinoprostone Vaginal Insert for Cervical Ripening/Labor Induction: A Prospective Double-Blind Study. Turkish-German Gynecology Assoc. 2008;9:206–217.
10. Kurian M, Rao B, Rao A, A S. Effect of vaginal pH on efficacy of dinoprostone gel for labour induction. Int J Reprod Contracept Obstet Gynecol. 2016;5(4):1196–1201. Available from: https://dx.doi.org/10.18203/2320-1770.ijrcog20160884.
Copyright (c) 2020 Author
This work is licensed under a Creative Commons Attribution 4.0 International License.