Dinoprostone priming of the cervix prior to termination of midgestation pregnancy with sulprostone

Abstract

Objective: To determine if cervical ripening with the prostaglandin E2 analogue dinoprostone effectively shortens the induction-to-delivery interval in midpregnancy terminations with sulprostone.

Study design: We retrospectively studied 100 women admitted for pregnancy termination at midgestation because of fetal anomalies between September 1989 and January 1993. Three regimens were used: 27 women received intramuscular sulprostone only, 29 women received intravenous sulprostone only, and 44 women received intravenous sulprostone after cervical priming with dinoprostone. Wilcoxon's rank sum test was used for statistical analysis.

Results: Dinoprostone priming did not significantly reduce the induction-to-delivery interval in either parous or nulliparous women. However, when divided into first and subsequent pregnancies, we found that primigravidae, but not multigravidae, had an induction-to-delivery interval that was significantly shorter by approximately 10.5 h when pretreated with dinoprostone.

Conclusion: Dinoprostone priming of the cervix prior to termination of midgestation pregnancy with sulprostone (Nalador) effectively shortens the induction-to-delivery interval in women in their first pregnancy.

PIP: The authors retrospectively studied 100 women admitted for pregnancy termination at midgestation because of fetal anomalies between September 1989 and January 1993 to determine if cervical ripening with the prostaglandin E2 analog dinoprostone shortens the induction-to-delivery interval in midpregnancy terminations with sulprostone. 27 women received intramuscular sulprostone only, 29 women received intravenous sulprostone only, and 44 women received intravenous sulprostone after cervical priming with dinoprostone. Dinoprostone priming failed to significantly reduce the induction-to-delivery interval in neither parous nor nulliparous women. Dividing into first and subsequent pregnancies, however, it was found that primigravidae and not multigravidae women had an induction-to-delivery interval which was significantly shorter by approximately 10.5 hours when pretreated with dinoprostone. Dinoprostone priming of the cervix prior to termination of midgestation pregnancy with sulprostone (Nalador) therefore effectively shortens the induction-to-delivery interval in women during their first pregnancy.