Journal of South Asian Federation of Obstetrics and Gynaecology

Register      Login

VOLUME 14 , ISSUE 6 ( November-December, 2022 ) > List of Articles

ORIGINAL RESEARCH

Dinoprostone Intravaginal Slow-release Insert for Labor Induction with and without Saline Vaginal Wash: A Randomized Controlled Trial

Reshmi Shanmugham, Rupal Samal, Divya Alamelu

Keywords : Dinoprostone, Prostaglandin, Vaginal pH, Vaginal washing

Citation Information : Shanmugham R, Samal R, Alamelu D. Dinoprostone Intravaginal Slow-release Insert for Labor Induction with and without Saline Vaginal Wash: A Randomized Controlled Trial. J South Asian Feder Obs Gynae 2022; 14 (6):700-703.

DOI: 10.5005/jp-journals-10006-2169

License: CC BY-NC 4.0

Published Online: 31-01-2023

Copyright Statement:  Copyright © 2022; The Author(s).


Abstract

Aim: To study the outcome of intravaginal dinoprostone insert for induction of labor with and without a saline vaginal wash. Materials and methods: A randomized controlled trial was conducted from October 2019 to June 2021 in the Department of Obstetrics and Gynaecology of a tertiary care center located in Puducherry, India. The total study population was 164. Participants were allocated into group I (n = 82) and group II (n = 82) based on computer-generated random numbers. A 20 mL of 0.9% NaCl wash was given intravaginally prior to insertion of dinoprostone for group I and no wash was given for group II. Duration of dinoprostone kept intravaginally, time from insertion to active stage, and full cervical dilatation was noted. The software used was statistical package for social sciences (SPSS) software, version 17. Results: Group I patients were found to attain the active stage of labor in 10 hours compared to group II patients who attained the active stage of labor in 14 hours. The difference between the mean duration of dinoprostone kept intravaginally, insertion to the active stage and full cervical dilatation were statistically significant. Conclusion: Thus, the labor duration for patients who underwent vaginal wash was less when compared to those who did not undergo vaginal washing. Vaginal pH has been shown to alter with vaginal washing. Vaginal washing before intravaginal dinoprostone insertion may increase the vaginal pH, and change the prostaglandin E2 (PGE2) vaginal insert bioavailability leading to shorter labor duration. Clinical significance: For pregnant women with planned labor induction, vaginal douching can be easily performed before intravaginal dinoprostone insertion and can provide safe and rapid labor.


PDF Share
  1. Wormer KC, Bauer A, Williford AE. Bishop Score. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022. Available at: http://www.ncbi.nlm.nih.gov/books/NBK470368/.
  2. Cunningham FG, editor. Williams Obstetrics, 25th edition. New York: McGraw-Hill; 2018.
  3. Shirley M. Dinoprostone vaginal insert: A review in cervical ripening. Drugs 2018(10);78(15):1615–1624.
  4. Önen Ş, Özakflit G, Yilmaz B, et al., The role of vaginal pH on efficacy of controlled-release dinoprostone vaginal insert for cervical ripening/labour induction: 206 a prospective double-blind study, J Turkish-German Gynecol Assoc 2008;9(4):206–211.
  5. Abide ÇY, Eken MK, Ozkaya E, et al. Effect of vaginal washing before intravaginal dinoprostone insertion for labor induction: A randomized clinical trial. J Obstet Gynaecol Res 2018;44(12):2149–2155. DOI: 10.1111/jog.13777.
  6. Şahin B, Çelik S, Soyer C, et al. Efficacy of vaginal douching before the application of dinoprostone pessary in labour induction: A randomized controlled study. Jinekoloji-Obstetrik ve Neonatoloji Tıp Dergisi 2020;17(3):431–434. DOI: 10.38136/jgon.696818.
  7. Shabir NA, Hanif S, Ehsan A, et al. Induction of labour with prostaglandin with or without vaginal douching. J Soc Obstet Gynaecol Pakistan 2020;10(3):159–164.
  8. Chodankar R, Sood A, Gupta J. An overview of the past, current and future trends for cervical ripening in induction of labour. Obstet Gynaecol 2017;19(3):219–226. https://doi.org/10.1111/tog.12395.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.