Repeated dose of prostaglandin E2 vaginal insert when the first dose fails

OBJECTIVE: To compare the obstetric and neonatal outcomes of patients treated with repeated-dose prostaglandin E2 (dinoprostone) vaginal insert when the first dose fails. MATERIALS AND METHODS: This retrospective study included 1.043 pregnant women who received dinoprostone for labor induction between November 2012 and August 2015. Pregnant women were divided into two groups according to the number of dinoprostone administrations: group 1, single-dose dinoprostone (n=1.000), and group 2, repeated-dose dinoprostone (n=43). Intrapartum, postpartum, and neonatal outcomes of the pregnant women were compared. RESULTS: Vaginal delivery rate was 65% in group 1 and 30.2% in group 2 (p=0.001). The need for the neonatal intensive care unit was found in 44 pregnant women (4.4%) in group 1 and 6 pregnant women (13.6%) in group 2 (p=0.006). CONCLUSION: When obstetric and neonatal data were evaluated in our study, we observed that dinoprostone administration was associated with increased cesarean rates and adverse neonatal outcomes with repeated-dose dinoprostone when the first dose failed.