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Vaginal Dinoprostone Insert versus Cervical Ripening Balloon for Term Induction of Labor in Obese Nulliparas—A Randomized Controlled Trial

Data regarding the preferred induction method in women with obesity is scarce. The current study was aimed at comparing pharmacological and mechanical induction in this population. This prospective randomized controlled trial was conducted between 2016–2020, in nulliparas with a pre-pregnancy body m...

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Autores principales: Lauterbach, Roy, Ben Zvi, Dikla, Dabaja, Haneen, Zidan, Ragda, Justman, Naphtali, Vitner, Dana, Beloosesky, Ron, Ghanem, Nadir, Ginsberg, Yuval, Zipori, Yaniv, Weiner, Zeev, Khatib, Nizar
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9029246/
https://www.ncbi.nlm.nih.gov/pubmed/35456231
http://dx.doi.org/10.3390/jcm11082138
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author Lauterbach, Roy
Ben Zvi, Dikla
Dabaja, Haneen
Zidan, Ragda
Justman, Naphtali
Vitner, Dana
Beloosesky, Ron
Ghanem, Nadir
Ginsberg, Yuval
Zipori, Yaniv
Weiner, Zeev
Khatib, Nizar
author_facet Lauterbach, Roy
Ben Zvi, Dikla
Dabaja, Haneen
Zidan, Ragda
Justman, Naphtali
Vitner, Dana
Beloosesky, Ron
Ghanem, Nadir
Ginsberg, Yuval
Zipori, Yaniv
Weiner, Zeev
Khatib, Nizar
author_sort Lauterbach, Roy
collection PubMed
description Data regarding the preferred induction method in women with obesity is scarce. The current study was aimed at comparing pharmacological and mechanical induction in this population. This prospective randomized controlled trial was conducted between 2016–2020, in nulliparas with a pre-pregnancy body mass index >30. Inclusion criteria were singleton-term pregnancies, bishop score < 5, and indication for induction. Patients were randomized to induction by a cervical ripening balloon (CRB) or a 10 mg vaginal dinoprostone insert. The primary outcome was delivery rate within 24 h. Secondary outcomes included time to delivery, cesarean section rate, maternal and neonatal outcomes, satisfaction, and anxiety. The study population comprised of 83 women in the CRB group and 81 in the dinoprostone group. There was a significant difference in delivery rates within 24 h and time to delivery between the dinoprostone and CRB groups (45% vs. 71%, p = 0.017 and 49.3 ± 6.8 h vs. 23.5 ± 5.9 h, p = 0.003, respectively). There were no differences in cesarean delivery rates or maternal and neonatal outcomes, though CRB induction was associated with a significantly lower rate of tachysystole. Induction with CRB was accompanied by higher satisfaction and lower anxiety. In summary, CRB induction is associated with shorter time to delivery, higher satisfaction, and lower anxiety compared to PGE2 in women with obesity, without compromising maternal or neonatal outcomes.
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spelling pubmed-90292462022-04-23 Vaginal Dinoprostone Insert versus Cervical Ripening Balloon for Term Induction of Labor in Obese Nulliparas—A Randomized Controlled Trial Lauterbach, Roy Ben Zvi, Dikla Dabaja, Haneen Zidan, Ragda Justman, Naphtali Vitner, Dana Beloosesky, Ron Ghanem, Nadir Ginsberg, Yuval Zipori, Yaniv Weiner, Zeev Khatib, Nizar J Clin Med Article Data regarding the preferred induction method in women with obesity is scarce. The current study was aimed at comparing pharmacological and mechanical induction in this population. This prospective randomized controlled trial was conducted between 2016–2020, in nulliparas with a pre-pregnancy body mass index >30. Inclusion criteria were singleton-term pregnancies, bishop score < 5, and indication for induction. Patients were randomized to induction by a cervical ripening balloon (CRB) or a 10 mg vaginal dinoprostone insert. The primary outcome was delivery rate within 24 h. Secondary outcomes included time to delivery, cesarean section rate, maternal and neonatal outcomes, satisfaction, and anxiety. The study population comprised of 83 women in the CRB group and 81 in the dinoprostone group. There was a significant difference in delivery rates within 24 h and time to delivery between the dinoprostone and CRB groups (45% vs. 71%, p = 0.017 and 49.3 ± 6.8 h vs. 23.5 ± 5.9 h, p = 0.003, respectively). There were no differences in cesarean delivery rates or maternal and neonatal outcomes, though CRB induction was associated with a significantly lower rate of tachysystole. Induction with CRB was accompanied by higher satisfaction and lower anxiety. In summary, CRB induction is associated with shorter time to delivery, higher satisfaction, and lower anxiety compared to PGE2 in women with obesity, without compromising maternal or neonatal outcomes. MDPI 2022-04-11 /pmc/articles/PMC9029246/ /pubmed/35456231 http://dx.doi.org/10.3390/jcm11082138 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Lauterbach, Roy
Ben Zvi, Dikla
Dabaja, Haneen
Zidan, Ragda
Justman, Naphtali
Vitner, Dana
Beloosesky, Ron
Ghanem, Nadir
Ginsberg, Yuval
Zipori, Yaniv
Weiner, Zeev
Khatib, Nizar
Vaginal Dinoprostone Insert versus Cervical Ripening Balloon for Term Induction of Labor in Obese Nulliparas—A Randomized Controlled Trial
title Vaginal Dinoprostone Insert versus Cervical Ripening Balloon for Term Induction of Labor in Obese Nulliparas—A Randomized Controlled Trial
title_full Vaginal Dinoprostone Insert versus Cervical Ripening Balloon for Term Induction of Labor in Obese Nulliparas—A Randomized Controlled Trial
title_fullStr Vaginal Dinoprostone Insert versus Cervical Ripening Balloon for Term Induction of Labor in Obese Nulliparas—A Randomized Controlled Trial
title_full_unstemmed Vaginal Dinoprostone Insert versus Cervical Ripening Balloon for Term Induction of Labor in Obese Nulliparas—A Randomized Controlled Trial
title_short Vaginal Dinoprostone Insert versus Cervical Ripening Balloon for Term Induction of Labor in Obese Nulliparas—A Randomized Controlled Trial
title_sort vaginal dinoprostone insert versus cervical ripening balloon for term induction of labor in obese nulliparas—a randomized controlled trial
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9029246/
https://www.ncbi.nlm.nih.gov/pubmed/35456231
http://dx.doi.org/10.3390/jcm11082138
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