Induction of Labor with Vaginal Dinoprostone (PGE<sub>2</sub>) in Patients with a Previous Cesarean Section: Obstetric and Neonatal Outcomes

Background: Vaginal dinoprostone (PGE<sub>2</sub>) is currently used as the prostaglandin of choice in many obstetric units. However, few studies have evaluated its safety, especially in women who previously had a cesarean section. Objective: To evaluate the efficacy and safety of PGE<...

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Autores principales:	Nuria López-Jiménez, Fiamma García-Sánchez, Rafael Hernández Pailos, Valentin Rodrigo-Álvaro, Ana Pascual-Pedreño, María Moreno-Cid, Antonio Hernández-Martínez, Milagros Molina-Alarcón
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	induction of labor trial of labor after cesarean (TOLAC) PGE<sub>2</sub> Medicine R
Acceso en línea:	https://doaj.org/article/71b81a4ee1184f848d6d3216f8381984
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spelling	oai:doaj.org-article:71b81a4ee1184f848d6d3216f83819842021-11-25T18:00:35ZInduction of Labor with Vaginal Dinoprostone (PGE<sub>2</sub>) in Patients with a Previous Cesarean Section: Obstetric and Neonatal Outcomes10.3390/jcm102252212077-0383https://doaj.org/article/71b81a4ee1184f848d6d3216f83819842021-11-01T00:00:00Zhttps://www.mdpi.com/2077-0383/10/22/5221https://doaj.org/toc/2077-0383Background: Vaginal dinoprostone (PGE<sub>2</sub>) is currently used as the prostaglandin of choice in many obstetric units. However, few studies have evaluated its safety, especially in women who previously had a cesarean section. Objective: To evaluate the efficacy and safety of PGE<sub>2</sub> in pregnant women who are undergoing induction of labor (IOL), and who have had a previous cesarean section. Materials and Methods: A prospective observational study was conducted in La Mancha Centro Hospital in Alcázar de San Juan, Spain, from 1 February 2019 to 30 August 2020. Obstetric and neonatal outcomes, following IOL with PGE<sub>2</sub>, in 47 pregnant women who wanted a trial of labor after cesarean (TOLAC), and 377 pregnant women without a history of cesarean section, were analyzed. The outcomes were analyzed by bivariate and multivariate analyses using binary and multiple linear regression. Results: A total of 424 women were included in this study. The percentage of cesarean sections in the TOLAC group was 44.7% (21), compared with 31.6% (119) in the group without a history of cesarean section (adjusted odds ratio: 1.4; 95% CI: 0.68–2.86). In the multivariate analysis, no statistically significant differences were observed between both groups for obstetric and neonatal outcomes (<i>p</i> > 0.05). However, two uterine ruptures (4.3%) occurred in the group of patients with a history of cesarean section who underwent IOL with PGE<sub>2</sub>. Conclusions: The induction of labor with vaginal dinoprostone (PGE<sub>2</sub>), in patients with a previous history of cesarean section, was not associated with worse obstetric or neonatal outcomes compared with the group of patients without a history of cesarean section in our study sample. However, further research is needed regarding this IOL method, and it should be used with caution in this population group.Nuria López-JiménezFiamma García-SánchezRafael Hernández PailosValentin Rodrigo-ÁlvaroAna Pascual-PedreñoMaría Moreno-CidAntonio Hernández-MartínezMilagros Molina-AlarcónMDPI AGarticleinduction of labortrial of labor after cesarean (TOLAC)PGE<sub>2</sub>MedicineRENJournal of Clinical Medicine, Vol 10, Iss 5221, p 5221 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	induction of labor trial of labor after cesarean (TOLAC) PGE<sub>2</sub> Medicine R
spellingShingle	induction of labor trial of labor after cesarean (TOLAC) PGE<sub>2</sub> Medicine R Nuria López-Jiménez Fiamma García-Sánchez Rafael Hernández Pailos Valentin Rodrigo-Álvaro Ana Pascual-Pedreño María Moreno-Cid Antonio Hernández-Martínez Milagros Molina-Alarcón Induction of Labor with Vaginal Dinoprostone (PGE<sub>2</sub>) in Patients with a Previous Cesarean Section: Obstetric and Neonatal Outcomes
description	Background: Vaginal dinoprostone (PGE<sub>2</sub>) is currently used as the prostaglandin of choice in many obstetric units. However, few studies have evaluated its safety, especially in women who previously had a cesarean section. Objective: To evaluate the efficacy and safety of PGE<sub>2</sub> in pregnant women who are undergoing induction of labor (IOL), and who have had a previous cesarean section. Materials and Methods: A prospective observational study was conducted in La Mancha Centro Hospital in Alcázar de San Juan, Spain, from 1 February 2019 to 30 August 2020. Obstetric and neonatal outcomes, following IOL with PGE<sub>2</sub>, in 47 pregnant women who wanted a trial of labor after cesarean (TOLAC), and 377 pregnant women without a history of cesarean section, were analyzed. The outcomes were analyzed by bivariate and multivariate analyses using binary and multiple linear regression. Results: A total of 424 women were included in this study. The percentage of cesarean sections in the TOLAC group was 44.7% (21), compared with 31.6% (119) in the group without a history of cesarean section (adjusted odds ratio: 1.4; 95% CI: 0.68–2.86). In the multivariate analysis, no statistically significant differences were observed between both groups for obstetric and neonatal outcomes (<i>p</i> > 0.05). However, two uterine ruptures (4.3%) occurred in the group of patients with a history of cesarean section who underwent IOL with PGE<sub>2</sub>. Conclusions: The induction of labor with vaginal dinoprostone (PGE<sub>2</sub>), in patients with a previous history of cesarean section, was not associated with worse obstetric or neonatal outcomes compared with the group of patients without a history of cesarean section in our study sample. However, further research is needed regarding this IOL method, and it should be used with caution in this population group.
format	article
author	Nuria López-Jiménez Fiamma García-Sánchez Rafael Hernández Pailos Valentin Rodrigo-Álvaro Ana Pascual-Pedreño María Moreno-Cid Antonio Hernández-Martínez Milagros Molina-Alarcón
author_facet	Nuria López-Jiménez Fiamma García-Sánchez Rafael Hernández Pailos Valentin Rodrigo-Álvaro Ana Pascual-Pedreño María Moreno-Cid Antonio Hernández-Martínez Milagros Molina-Alarcón
author_sort	Nuria López-Jiménez
title	Induction of Labor with Vaginal Dinoprostone (PGE<sub>2</sub>) in Patients with a Previous Cesarean Section: Obstetric and Neonatal Outcomes
title_short	Induction of Labor with Vaginal Dinoprostone (PGE<sub>2</sub>) in Patients with a Previous Cesarean Section: Obstetric and Neonatal Outcomes
title_full	Induction of Labor with Vaginal Dinoprostone (PGE<sub>2</sub>) in Patients with a Previous Cesarean Section: Obstetric and Neonatal Outcomes
title_fullStr	Induction of Labor with Vaginal Dinoprostone (PGE<sub>2</sub>) in Patients with a Previous Cesarean Section: Obstetric and Neonatal Outcomes
title_full_unstemmed	Induction of Labor with Vaginal Dinoprostone (PGE<sub>2</sub>) in Patients with a Previous Cesarean Section: Obstetric and Neonatal Outcomes
title_sort	induction of labor with vaginal dinoprostone (pge<sub>2</sub>) in patients with a previous cesarean section: obstetric and neonatal outcomes
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/71b81a4ee1184f848d6d3216f8381984
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Induction of Labor with Vaginal Dinoprostone (PGE<sub>2</sub>) in Patients with a Previous Cesarean Section: Obstetric and Neonatal Outcomes

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