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Clinical significances of Bishop score and vaginal bleeding to controlled‐release dinoprostone delivery system (PROPESS) efficacy for cervical ripening: A retrospective single‐center study in Japan.
- Source :
- Journal of Obstetrics & Gynaecology Research; Apr2023, Vol. 49 Issue 4, p1154-1160, 7p
- Publication Year :
- 2023
-
Abstract
- Aims: To evaluate the effect of vaginal bleeding on the efficacy of controlled‐release dinoprostone delivery system (PROPESS) for cervical ripening and the factors affecting the PROPESS efficacy in a Japanese clinical setting. Methods: A total of 100 term pregnant women in whom PROPESS was used due to an unfavorable cervix (Bishop score ≤ 6) were enrolled. We retrospectively investigated which factors, including vaginal bleeding, were associated with the success of cervical ripening using logistic regression analysis. Moreover, the effect of vaginal bleeding on vaginal acidity was examined in 24 selected cases (control, 11; rupture of membrane, 4; and vaginal bleeding, 8). Results: A 25 women successfully ripened the cervix (effective group), and 75 were unsuccessful (noneffective group). Bishop score at insertion (adjusted odds ratio: 1.87; 95% confidence interval: 1.23–2.86; p = 0.004), and vaginal bleeding at PROPESS insertion (adjusted odds ratio 6.63; 95% confidence interval 1.21–36.36; p = 0.029) affected cervical ripening success. The cases with vaginal bleeding showed a significantly higher vaginal pH than the control cases (median value: 6.75 and 5.0, respectively). We identified no obvious adverse outcomes, such as tachysystole, fetal heart rate abnormality, or low Apgar/pH, associated with vaginal bleeding at insertion. Conclusions: Our findings suggest that the PROPESS efficacy depends on Bishop score at insertion and that vaginal bleeding at PROPESS insertion might have a significantly positive effect on cervical ripening in term pregnant women. [ABSTRACT FROM AUTHOR]
- Subjects :
- UTERINE hemorrhage
DRUG efficacy
INDUCED labor (Obstetrics)
CONFIDENCE intervals
HYDROGEN-ion concentration
DINOPROSTONE
RETROSPECTIVE studies
PREGNANT women
FISHER exact test
MANN Whitney U Test
PESSARIES
PREGNANCY outcomes
CONTROLLED release preparations
APGAR score
ODDS ratio
FETAL anoxia
DATA analysis software
Subjects
Details
- Language :
- English
- ISSN :
- 13418076
- Volume :
- 49
- Issue :
- 4
- Database :
- Complementary Index
- Journal :
- Journal of Obstetrics & Gynaecology Research
- Publication Type :
- Academic Journal
- Accession number :
- 162842797
- Full Text :
- https://doi.org/10.1111/jog.15575