Efficacy and safety of slow release dinoprostone insert for induction of labor: Correlation with parity

Objective To evaluate the clinical efficacy and safety of vaginal dinoprostone, a prostaglandin insert in cervical ripening and induction of labor in various clinical conditions. Methods A retrospective study including a group of pregnant women( n = 241 ) who received dinoprostone by vaginal slow release insert for induction of labor on the basis of various indications was conducted. The prognostic factors were: maternal age, parity, gestational age, Bishop score. The main outcome was induction-delivery interval; secondary outcomes were the number of dinoprostone applications and the application-ripening internal. Data were analyzed by chi-square test with continuity correction and Cox regression. Results A group of women (n = 160) went into active labor within 24 h from the vaginal insert, and of these 1 within 12 h. The induction-delivery interval was significantly related to the parity. The mean time for cervical ripening was 21 h and the interval to delivery was 26 h. Failure of cervical ripening occurred in 34 cases out 241, and was not related to gestational age( χ² = 0.29 ; P = 0. 59 ) or parity ( χ² = 1.75 ;P = 0. 18 ). Conclusion The use of vaginal slow release dinoprostone insert for labor induction is highly efficacious and with no side effects. Parity is the only independent factor to predict induction-delivery interval.