Dinoprostone pessary for labor induction in Chinese patients with premature rupture of membranes at term: A retrospective cohort

Aim: Whether the use of dinoprostone pessary increased the vaginal delivery rate of labor induction in Chinese nulliparous women with term premature rupture of membranes (PROM) and unfavorable cervices?

Methods: PROM women at term with singleton pregnancies and Bishop scores ≤4 who needed labor induction were enrolled in this retrospective study. They received either the dinoprostone pessary followed by oxytocin infusion if necessary (n = 102, PGE2 group) or oxytocin infusion alone (n = 103, oxytocin group).

Results: Compared with oxytocin infusion alone, vaginal delivery within 12 h and total vaginal delivery were higher in the PGE2 group (28.4% vs 7.8%, p = 0.0001; 79.4% vs 62.1%, p = 0.009, respectively). There were no statistical differences between the two groups in terms of maternal and neonatal outcomes, such as postpartum hemorrhage, endometritis, third- and fourth-degree vaginal lacerations and neonatal weight, 1- and 5-min Apgar score ≤7, neonatal jaundice, and neonatal unit admission (p > 0.05). However, there was a higher rate of uterine hyperstimulation in the PGE2 group (20.6% vs 3.9%, p < 0.0001). The effective rate of cervical ripening increased in the PGE2 group at 8 and 12 h of labor induction (p < 0.001).

Conclusions: Despite higher rates of uterine hyperstimulation, the use of dinoprostone was associated with higher rates of vaginal deliveries in Chinese nulliparous women with term PROM and Bishop scores ≤4, compared with use of oxytocin only.