Induction of Labor with Vaginal Dinoprostone (PGE 2 ) in Patients with a Previous Cesarean Section: Obstetric and Neonatal Outcomes.

Autor: López-Jiménez N; Department of Obstetrics and Gynecology, La Mancha Centro Hospital, 13600 Alcázar de San Juan, Spain., García-Sánchez F; Department of Obstetrics and Gynecology, La Mancha Centro Hospital, 13600 Alcázar de San Juan, Spain., Pailos RH; Department of Obstetrics and Gynecology, La Mancha Centro Hospital, 13600 Alcázar de San Juan, Spain., Rodrigo-Álvaro V; Department of Obstetrics and Gynecology, La Mancha Centro Hospital, 13600 Alcázar de San Juan, Spain., Pascual-Pedreño A; Department of Obstetrics and Gynecology, La Mancha Centro Hospital, 13600 Alcázar de San Juan, Spain., Moreno-Cid M; Department of Obstetrics and Gynecology, La Mancha Centro Hospital, 13600 Alcázar de San Juan, Spain., Hernández-Martínez A; Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Nursing, University of Castilla-La Man cha IDINE, Camilo José Cela, 14, 13071 Ciudad Real, Spain., Molina-Alarcón M; Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Nursing, University of Castilla-La Man cha IDINE, Camilo José Cela, 14, 13071 Ciudad Real, Spain.
Jazyk: angličtina
Zdroj: Journal of clinical medicine [J Clin Med] 2021 Nov 09; Vol. 10 (22). Date of Electronic Publication: 2021 Nov 09.
DOI: 10.3390/jcm10225221
Abstrakt: Background: Vaginal dinoprostone (PGE 2 ) is currently used as the prostaglandin of choice in many obstetric units. However, few studies have evaluated its safety, especially in women who previously had a cesarean section.
Objective: To evaluate the efficacy and safety of PGE 2 in pregnant women who are undergoing induction of labor (IOL), and who have had a previous cesarean section.
Materials and Methods: A prospective observational study was conducted in La Mancha Centro Hospital in Alcázar de San Juan, Spain, from 1 February 2019 to 30 August 2020. Obstetric and neonatal outcomes, following IOL with PGE 2 , in 47 pregnant women who wanted a trial of labor after cesarean (TOLAC), and 377 pregnant women without a history of cesarean section, were analyzed. The outcomes were analyzed by bivariate and multivariate analyses using binary and multiple linear regression.
Results: A total of 424 women were included in this study. The percentage of cesarean sections in the TOLAC group was 44.7% (21), compared with 31.6% (119) in the group without a history of cesarean section (adjusted odds ratio: 1.4; 95% CI: 0.68-2.86). In the multivariate analysis, no statistically significant differences were observed between both groups for obstetric and neonatal outcomes ( p > 0.05). However, two uterine ruptures (4.3%) occurred in the group of patients with a history of cesarean section who underwent IOL with PGE 2 .
Conclusions: The induction of labor with vaginal dinoprostone (PGE 2 ), in patients with a previous history of cesarean section, was not associated with worse obstetric or neonatal outcomes compared with the group of patients without a history of cesarean section in our study sample. However, further research is needed regarding this IOL method, and it should be used with caution in this population group.
Databáze: MEDLINE
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