Labor Induction With Prostaglandin E2- Experience Of A Maternity And Children’s Disease Hospital

Yıl 2016, Cilt: 13 Sayı: 2, 61 - 64, 01.04.2016

Mehmet Şükrü Budak Cihan Kaya , Sedat Akgöl Mehmet Baki Şentürk Mine Kanat Pektaş Neval Yaman Görük Önder Tosun

Öz

Aim: The present study aims to make an epidemiological and clinical assessment of term pregnancies that received labor induction by prostaglandin E2 dinoprostone within the last two years in our hospital.Material and Methods: We evaluated 1477 pregnants who had admitted to our hospital with term pregnancies gestational age ≥ 37 weeks , unfavorable cervix Bishop score ≤ 4 and had labor induction with dinoproston due to oligohydramnios or surmaturation in this study.Results: Cesarean delivery and tachysystole rates were 26.4 % and 5.8 % in pregnants with labor induction, respectively. The patients who delivered vaginally after dinoprostone induction were compared with those who delivered by cesarean section after dinoprostone induction. The cesarean section group had significantly lower parity p=0.001 , longer gestation p=0.001 , longer latent labor phase p=0.001 and higher risk of hyperstimulation p=0.02 than the vaginal delivery group. Fetal distress 46.7 % , failure for labor progression 31.3 % and cephalopelvic disproportion 15.4 % were the most frequent indications for cesarean delivery.Conclusion: Prostaglandin E2 is safe and efficient agent used for cervical maturation. Although dinoprostone increases cesarean delivery rates, it does not affect fetal APGAR scores.

Anahtar Kelimeler

Labor induction, prostaglandin E2, cesarean section

Prostaglandin E2 ile Doğum İndüksiyonu: Kadın Doğum ve Çocuk Hastalıkları Hastanesi Deneyimi

Öz

Amaç: Bu çalışma, hastanemizde son iki yılda prostaglandin E2 dinoprostone ile doğum indüksiyonu uygulanan term gebelik olgularını epidemiyolojik ve klinik bakımdan değerlendirmeyi amaçlamaktadır.Gereç ve Yöntemler: Bu çalışmada term gebelikte gebelik haftası ≥ 37 hafta , uygunsuz serviksi olan Bishop skoru ≤ 4 olan, oligohidramnios veya gün aşımı nedeniyle dinoproston ile doğum indüksiyonu almış 1477 gebeyi inceledik.Bulgular: Doğum indüksiyonu uygulanan gebelerde sezaryenle doğum ve taşisistol oranları sırasıyla % 26.4 ve % 5.8 olarak bulundu. Dinoproston indüksiyonu sonrası vajinal doğum yapanlarla dinoproston sonrası sezaryen doğum yapan hastalar kıyaslandı. Sezaryen grubunda anlamlı derecede daha düşük parite sayısı p=0.001 , daha uzun gebelik süresi p=0.001 , daha uzun latent doğum evresi p=0.001 daha fazla hiperstimülasyon riski p=0.02 vajinal doğum grubuna göre saptandı. Fetal distres % 46.7 , ilerlemeyen eylem % 31.3 ve sefalopelvik uyumsuzluk % 15.4 , sezaryenle doğumlar için en sıklıkla kaydedilen endikasyonlardı.Sonuç: Prostaglandin E2, servikal olgunluğu sağlamak için kullanılan etkin ve güvenilir ajandır. Her nekadar dinoproston sezaryenle doğum oranlarını arttırsa da fetal APGAR skorlarını etkilememektedir.

Anahtar Kelimeler

Doğum indüksiyonu, prostaglandin E2, sezaryen

Kaynakça

• Daskalakis G, Zacharakis D, Simou M, Pappa P, Detorakis S, Mesogitis S, et al. Induction of labor versus expectant management for pregnancies beyond 41 weeks. J Matern Fetal Neonatal Med 2014;27:173-6.
• Haq AN, Ahsan S, Sher Z. Induction of labour in postdates pregnant women. J Coll Physicians Surg Pak 2012;22:644-7.
• Tam T, Conte M, Schuler H, Malang S, Roque M. Delivery outcomes in women undergoing elective labor induction at term. Arch Gynecol Obstet 2013;287:407-11.
• Hawkins JS, Wing DA. Current pharmacotherapy options for labor induction. Expert Opin Pharmacother 2012;13:2005-14.
• Yount SM, Lassiter N. The pharmacology of prostaglandins for induction of labor. J Midwifery Womens Health 2013;58:133-44.
• Akpınar Alyamaç F, Özerkan K, Altun O, Esmer A, Arslan E. Miad gebelikte serviksin olgunlaştırılmasında prostaglandin analoglarının karşılaştırılması. TJOD Derg 2008;6:27-34.
• Yörük Ö, Öksüzoğlu A, Engin-Üstün Y, Aktulay A, Yapar Eyi EG, Erkaya S. Bishop skoru 4 ve altında olan gebelerde doğum indüksiyonunda dinoproston ve oksitosin kullanılmasının karşılaştırılması. Perinatoloji Dergisi 2013;21:107-12.
• Phelan JP, Ahn MO, Smith CV, Rutherford SE, Anderson E. Amniotic fluid index measurements during pregnancy. J Reprod Med 1987;32:601-4.
• Galal M, Symonds I, Murray H, Petraglia F, Smith R. Postterm pregnancy. Facts Views Vis Obgyn 2012;4:175-87.
• Tsvieli O, Sergienko R, Sheiner E. Risk factors and perinatal outcome of pregnancies complicated with cephalopelvic disproportion: a population- based study. Arch Gynecol Obstet. 2012;285:931-6.
• Ulubaşoğlu H, Özmen Bayar Ü, Kaya C, Ungan B. The effect of nifedipine tocolysis on Doppler indices of the uterine and umbilical arteries. J Clin Ultrasound 2015;43:322-6.
• Tilden EL, Lee VR, Allen AJ, Griffin EE, Caughey AB. Cost-Effectiveness Analysis of Latent versus Active Labor Hospital Admission for Medically Low-Risk, Term Women. Birth 2015; 22.
• Pinas A, Chandraharan E. Continuous cardiotocography during labour: Analysis, classification and management. Best Pract Res Clin Obstet Gynaecol 2015; 25: 1521-5.
• Winer N. Different methods for the induction of labour in postterm pregnancy. J Gynecol Obstet Biol Reprod (Paris) 2011;40:796-811.
• Mozurkewich EL, Chilimigras JL, Berman DR, Perni UC, Romero VC, King VJ, et al. Methods of induction of labour: a systematic review. BMC Pregnancy Childbirth 2011: 27;11:84.
• Melamed N, Yariv O, Hiersch L, Wiznitzer A, Meizner I, Yogev Y. Labor induction with prostaglandin E2: characteristics of response and prediction of failure. J Matern Fetal Neonatal Med 2013;26:132-6.
• Tinelli A, Tinelli R, Tinelli FG. Induction of labour: which method to use? Minerva Ginecol 2003;55:463-82.
• Justus Hofmeyr G. Induction of labour with an unfavourable cervix. Best Pract Res Clin Obstet Gynaecol 2003;17:777-94.
• Petrovic Barbitch M, Gnisci A, Marcelli M, Capelle M, Guidicelli B, Cravello L, et al. Cervical ripening at term with repeated administration of dinoprostone vaginal pessary. Gynecol Obstet Fertil 2013;41:346-50.
• Faucett AM, Daniels K, Lee HC, El-Sayed YY, Blumenfeld YJ. Oral misoprostol versus vaginal dinoprostone for labor induction in nulliparous women at term. J Perinatol 2014;34:95-9.
• Henry A, Madan A, Reid R, Tracy SK, Austin K, Welsh A, et al. Outpatient Foley catheter versus inpatient prostaglandin E2 gel for induction of labour: a randomised trial. BMC Pregnancy Childbirth. 2013: 29;13:25.
• Tathem K, Harris LJ, O’Rourke P, Kimble RM. Dinoprostone vaginal pessary for induction of labour: safety of use for up to 24 h. Aust N Z J Obstet Gynaecol 2012;52:582-7.
• Chitrakar NS. Comparison of Misoprostol versus Dinoprostone for pre-induction cervical ripening at-term. J Nepal Health Res Counc 2012;10:10-5.
• Gungorduk K, Yildirim G, Gungorduk O, Ark C, Tekirdag I. Sustained- release dinoprostone vaginal pessary with concurrent high-dose oxytocin infusion compared to sustained-release dinoprostone vaginal pessary followed 6 h later by high-dose oxytocin infusion for labor induction in women at term with unfavorable cervix: a randomized controlled trial. Gynecol Obstet Invest 2011;71:32-40.