COMPARISON OF DINOPROSTONE PLUS ‎OXYTOCIN AND OXYTOCIN ALONE FOR INDUCTION ‎OF LABOR

Abstract

Role of labor induction has increased in the last decade due to the ‎early detection of fetal jeopardy. Although very useful, oxytocin alone is not always successful for induction of ‎labor. In a randomized clinical ‎trial we compared vaginal dinoprostone plus oxytocin with oxytocin alone for ‎induction of labor in 91 ‎pregnant women at 40 weeks or greater gestation with Bishop scores ≤ 4. Forty six patients ‎assigned to the dinoprostone group received 3 mg intravaginal dinoprostone. Six ‎hours later the Bishop score was evaluated and if the patient had not at least 3 contractions in ‎10 minutes lasting for more than 40 seconds, intravenous oxytocin was started at a dose of 6 mu/min and ‎increased by 6 mu/min at 40 minute intervals until adequate uterine activity. Forty five patients ‎assigned to the oxytocin group underwent oxytocin induction from the start of labor induction. ‎Although the Bishop score change after 6 hours of receiving vaginal dinoprostone from 2.54 ‎to 4.97 was statistically significant, the oxytocin only group had a much better response with a change from ‎2.60 to 6.28. Median time between induction to the start of active labor was significantly ‎shorter in the oxytocin alone group (P = 0.04). Median time between ‎induction to delivery and the rate of cesarean did not differ significantly in two groups (P > ‎0.05). It was concluded that single dose of ‎dinoprostone is effective for initiating labor in patients with an unfavorable cervix and ‎appears safe but it is not as effective as oxytocin.