TITLE:
Comparative study for success rate of vaginal birth after cesarean section following labor induction by two forms of vaginal dinosprostone: A pilot study
AUTHORS:
Mahmoud Fathy Hassan, Osama El-Tohamy
KEYWORDS:
Dinoprostone; Induction of Labor; Trial of Labor after Cesarean; TOLAC; Vaginal Birth after Cesarean; VBAC
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.4 No.1,
January
10,
2014
ABSTRACT:
Background: Cesarean delivery has become the most
common major surgical procedure in many parts of the world. Induction of labor
in women with prior cesarean delivery is an alternative to mitigate the rising
cesarean rates. Objectives: To compare the VBAC success rate between two
vaginal forms of dinoprostone for labor induction in women with prior cesarean
section. Material and Methods: A pilot study was
conducted at a large Governmental Hospital, Dhahran, Saudi Arabia,
including 200 women with prior cesarean
section and planned for labor induction. Participants were randomly
allocated into two groups. Group A (n = 100) received dinoprostone 1.5 mg vaginal
tablet. Group B (n = 100) received 10 mg dinoprostone sustained release vaginal
pessary. Primary outcome was vaginal delivery rate. Secondary outcomes included
maternal and neonatal outcomes. Results: The dinoprostone vaginal tablet and
dinoprostone vaginal pessary had a comparable vaginal delivery rate (67% and
64%, respectively; p = 0.78). The median patient satisfaction with the birth
process was superior in the dinoprostone vaginal pessary group (p = 0.04).
Maternal and neonatal outcomes were similar in both groups. Conclusion: Both
forms of dinoprostone were effective methods for labor induction in women with
prior cesarean section. However, the patient satisfaction with the birth
process was in favor of the dinoprostone sustained release vaginal pessary.