Obesity and cervical ripening failure risk

J Matern Fetal Neonatal Med. 2012 Mar;25(3):304-7. doi: 10.3109/14767058.2011.575485. Epub 2011 May 17.

Abstract

Objective: To estimate the impact of obesity on cervical ripening with prostaglandin E2 (PGE2).

Materials and method: A retrospective study compared the cervical ripening efficiency of PGE2 on patients with BMI above 30 kg/m(2) and normal weight patients with BMI between 20 kg/m(2) and 25 kg/m(2). In case of a Bishop score (≤3), a dinoprostone tampon was used over 12 h. In case of a Bishop score (4;6), a dinoprostone gel was used over 6 h. Failure of first cervical ripening attempt was defined, as the persistence of a Bishop score <6, 12 h after dinoprostone tampon or 6 h after dinoprostone gel.

Results: Ninety-five obese patients were matched according to parity to 190 non-obese patients. The failure rate of the first attempt at cervical ripening was significantly higher (P = 0.0016) among obese patients (53.7%) as compared to patients with a BMI in between 20 and 25 (34.2%). After multivariate analysis BMI ≥ 30 (OR = 2.32 (1.47-4.00), P = 0.0019), parity ≤2 (OR = 2.50 (1.20-5.26) P = 0.0137), and the Bishop score ≤3 (OR = 2.62 (1.45-4.72), P = 0.0014) were significantly and independently associated to prostaglandin ripening failure.

Conclusion: Obesity seems to be associated to lower E2 prostaglandin sensitivity.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Body Mass Index
  • Cervical Ripening*
  • Cervix Uteri / drug effects*
  • Cohort Studies
  • Dinoprostone / pharmacology
  • Dinoprostone / therapeutic use*
  • Female
  • Humans
  • Labor, Induced / methods*
  • Logistic Models
  • Obesity / complications*
  • Oxytocics / pharmacology
  • Oxytocics / therapeutic use*
  • Pregnancy
  • Pregnancy Complications*
  • Retrospective Studies
  • Treatment Failure
  • Young Adult

Substances

  • Oxytocics
  • Dinoprostone