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. 2017 Mar;60(2):163-169.
doi: 10.5468/ogs.2017.60.2.163. Epub 2017 Mar 16.

Predicting factors for success of vaginal delivery in preterm induction with prostaglandin E2

Yoo Min Kim  1 , Ju Young Park  1 , Ji-Hee Sung  1 , Suk-Joo Choi  1 , Soo-Young Oh  1 , Cheong-Rae Roh  1 , Jong-Hwa Kim  1
Affiliations

Predicting factors for success of vaginal delivery in preterm induction with prostaglandin E2

Yoo Min Kim et al. Obstet Gynecol Sci. 2017 Mar.

Abstract

Objective: To evaluate the efficacy and safety of prostaglandin (PG) E2 for preterm labor induction and to investigate the predictive factors for the success of vaginal delivery.

Methods: A retrospective cohort study was performed in women (n=155) at 24+0 to 36+6 weeks of gestation who underwent induction of labor using a PGE2 vaginal pessary (10 mg, Propess) from January 2009 to December 2015. Success rates of vaginal delivery according to gestational age at induction and incidence of intrapartum complications such as tachysystole and nonreassuring fetal heart rate were investigated. Multivariable logistic regression analysis was performed to evaluate the predictive factors for success of labor induction.

Results: The vaginal delivery rate was 57% (n=89) and the rate of cesarean delivery after induction was 43% (n=66). According to gestational age, labor induction was successful in 16.7%, 50.0%, and 62.8% of patients at 24 to 31, 32 to 33, and 34 to 36 weeks, showing a stepwise increase (P=0.006). There were 18 cases (11%) of fetal distress, 9 cases (5.8%) of tachysystole, and 6 cases (3.8%) of massive postpartum bleeding (>1,000 mL). After adjusting for confounding factors, multiparity (odds ratio [OR], 8.47; 95% confidence interval [CI], 3.10 to 23.14), younger maternal age (OR, 0.84; 95% CI, 0.75 to 0.94), advanced gestational age at induction (OR, 1.06; 95% CI, 1.02 to 1.09), rupture of membranes (OR, 11.83; 95% CI, 3.55 to 39.40), and the Bishop score change after removal of PGE2 (OR, 2.19; 95% CI, 1.0 to 4.8) were significant predictors of successful preterm vaginal delivery.

Conclusion: An understanding of the principal predictive factors of successful preterm labor induction, as well as the safety of PGE2, will provide useful information when clinicians consult with preterm pregnant women requiring premature delivery.

Keywords: Dinoprostone; Labor, induced; Premature birth; Vaginal delivery; Vaginal pessary.

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Conflict of interest statement

Conflict of interest: No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1. Success rate of vaginal delivery according to gestational age at induction.
Fig. 2
Fig. 2. Multiple logistic regression analyses of success of vaginal delivery. OR, odds ratio; CI, confidence interval.
See this image and copyright information in PMC

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