International Journal of Gynecological Endoscopy

Register      Login

SEARCH WITHIN CONTENT

FIND ARTICLE

Volume / Issue

Online First

Related articles

VOLUME 1 , ISSUE 1 ( January-March, 2017 ) > List of Articles

ORIGINAL ARTICLE

A Randomized Controlled Trial of Extra-amniotic Saline Infusion vs Intracervical Dinoprostone Gel for Induction of Labor

Steffi V Rodrigues, MK Swamy, Namrata Jadhav

Citation Information : Rodrigues SV, Swamy M, Jadhav N. A Randomized Controlled Trial of Extra-amniotic Saline Infusion vs Intracervical Dinoprostone Gel for Induction of Labor. Int J Gynecol Endsc 2017; 1 (1):11-17.

DOI: 10.5005/jp-journals-10058-0003

License: CC BY 3.0

Published Online: 01-08-2013

Copyright Statement:  Copyright © 2017; The Author(s).


Abstract

Background

Success of induction depends largely on cervical ripening and increases the likelihood of vaginal delivery. This study compared the outcomes for induction of labor using extra-amniotic saline infusion (EASI) vs intracervical dinoprostone gel.

Objective:

Primary: To compare improvement between pre- and post-induction Bishop’s scores in both the groups.

Secondary: To compare induction to delivery interval, mode of delivery, and neonatal outcome in both the groups.

Materials and methods

A randomized controlled trial of 1 year was conducted in the Department of Obstetrics and Gynaecology, Karnataka Lingayat Education University Dr Prabhakar Kore Hospital and Medical Research Centre, Belagavi, Karnataka, India, on 82 pregnant women from January 2014 to December 2014. The selected women were divided into two groups of 41 each as group I (induced with dinoprostone) and group II (induced with EASI using Foley’s catheter).

Results

Significantly higher number of women had postinduction Bishop’s scores between 9 and 12 in the dinoprostone group (70.73%; p < 0.001). The mean Bishop’s scores were significantly high in the dinoprostone gel (9.27 ± 3.07) vs EASI (8.22 ± 2.34; p = 0.086). Cervical ripening based on cut-off score of ≥6 was noted in a significantly higher number of women (92.68%) in EASI (p = 0.241). The mean time for cervical ripening was significantly high in dinoprostone gel group compared with EASI (15.44 ± 8.41 vs 3.88 ± 3.67; p < 0.001), but mean induction to delivery time was comparable (p = 0.086). Significantly higher numbers of vaginal deliveries were noted in dinoprostone group (91.43%; p = 0.001). The neonatal outcomes, i.e., birth weight, mean birth weight, appearance, pulse, grimace, activity, and respiration score at 1 and 5 minutes, and neonatal intensive care unit admission, were comparable (p = 0.570).

Conclusion

Dinoprostone gel and EASI using Foley’s catheter appear to be effective methods for cervical ripening and labor induction, but dinoprostone gel yielded significantly higher rate of vaginal delivery.

How to cite this article

Rodrigues SV, Swamy MK, Jadhav N. A Randomized Controlled Trial of Extra-amniotic Saline Infusion vs Intracervical Dinoprostone Gel for Induction of Labor. Int J Gynecol Endsc 2017;1(1):11-17


HTML PDF Share
  1. Induction and Augmentation of labor: basis and methods for current practice. Obstet Gynecol Surv 1988 Dec;43(12):730-743.
  2. Patterns and outcomes of induction of labour in Africa and Asia: a secondary analysis of the WHO Global Survey on Maternal and Neonatal Health. PLoS One 2013;8(6):e65612.
  3. Induction of labor in a contemporary obstetric cohort. Am J Obstet Gynecol 2012 Jun;206(6):486.e1-486.e9.
  4. Induction of labor in the absence of standard medical indications: incidence and correlates. Med Care 2007 Jun;45(6):505-512.
  5. Induction of labor. Obstet Gynecol Clin North Am 2005 Jun;32(2):181-200, viii.
  6. Comparison of the efficacy of Foley catheter balloon with dinoprostone gel for cervical ripening at term. Int J Clin Med 2012 Nov;3(6):527-531.
  7. Onge RD, Connors GT. Preinduction cervical ripening: a comparison of intracervical prostaglandin E2 gel versus the Foley catheter. Am J Obstet Gynecol 1995 Feb;172(2 Pt 1):687-690.
  8. The use of Foley’s catheter in ripening the unfavourable cervix prior to induction of labour. Br J Obstet Gynaecol 1980 Apr;87(4):281-286.
  9. A randomized comparison of extra-amniotic saline infusion and intracervical dinoprostone gel for cervical ripening. Obstet Gynecol 1999 Feb;93(2):271-274.
  10. Ripening the highly unfavorable cervix with extra-amniotic saline instillation or vaginal prostaglandin E2 application. Obstet Gynecol 1989;73:938-942.
  11. A randomized trial of extra-amniotic saline infusion plus intracervical Foley catheter balloon versus prostaglandin E2 vaginal gel for ripening the cervix and inducing labor in patients with unfavorable cervices. Obstet Gynecol 1993 Aug;82(2):290-294.
  12. Ripening of the unfavorable cervix with extraamniotic catheter balloon: clinical experience and review. Obstet Gynecol Surv 1996 Oct;51(10):621-627.
  13. A randomized trial comparing a 30-mL and an 80-mL Foley catheter balloon for preinduction cervical ripening. Am J Obstet Gynecol 2004 Nov;191(5):1632-1636.
  14. Induction of labor by Foley’s Catheter method. A clinical study of forty cases. Bangladesh J Obstet Gynaecol 1994;9(1):16-21.
  15. Induction of labour. J Obstet Gynaecol Can 2013 Sep;35(9):840-860.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.