Labor induction with prostaglandin E2: characteristics of response and prediction of failure.
Summary of "Labor induction with prostaglandin E2: characteristics of response and prediction of failure."
Objective: To characterize the response to labor induction with prostaglandin E2 (PGE2) and to identify risk factors for induction failure. Methods: A prospective controlled study of women admitted for labor induction with PGE2. Maternal characteristics, Bishop score and sonographic cervical length were documented at admission. The change in cervical characteristics and the emergence of uterine contractions following each application of PGE2 were analyzed. Results: Of the 88 women who were included in the study, 19 (21.6%) failed to response to PGE2. The following factors were independently associated with induction failure: nulliparity (odds ratio [OR] = 5.9, 95% confidence interval (CI): 1.2-30.2), pre-pregnancy body mass index >25 kg/m2 (OR = 5.4, 95%
CI:
1.1-26.5), Bishop score <4 (OR = 2.3, 95%
CI:
1.05-14.4), cervical length <25 mm (OR = 0.2, 95%
CI:
0.1-0.8) and the development of uterine contractions in response to the first application of PGE2 (OR = 0.4, 95%
CI:
0.1-0.93). Overall, most women required only one (60.9%) or two (85.5%) applications of PGE2 to achieve successful induction. The number of applications of PGE2 required to achieve successful induction was related to parity and cervical status at presentation. Conclusions: Overall, most women who eventually respond to PGE2 do so following the first two applications of PGE2, and the contribution of subsequent applications is relatively small and related to cervical status at admission.
Affiliation
Helen Schneider Hospital for Women, Rabin Medical Center , Petach Tikva , Israel.
Journal Details
This article was published in the following journal.
Name: The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the
ISSN: 1476-4954
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/22928537
- DOI: http://dx.doi.org/10.3109/14767058.2012.722729
Medical and Biotech [MESH] Definitions
Growth Differentiation Factor 15
A growth differentiation factor that is secreted in response to cell stress and in response to MACROPHAGE ACTIVATION. In addition growth differentiation factor 15 demonstrates a diverse array of biological properties including the induction of cartilage formation, the inhibition of hematopoietic progenitor proliferation, and the induction of neuronal migration.
Receptors, Prostaglandin
Cell surface receptors that bind prostaglandins with high affinity and trigger intracellular changes which influence the behavior of cells. Prostaglandin receptor subtypes have been tentatively named according to their relative affinities for the endogenous prostaglandins. They include those which prefer prostaglandin D2 (DP receptors), prostaglandin E2 (EP1, EP2, and EP3 receptors), prostaglandin F2-alpha (FP receptors), and prostacyclin (IP receptors).
Unfolded Protein Response
A cellular response to environmental insults that cause disruptions in PROTEIN FOLDING and/or accumulation of defectively folded protein in the ENDOPLASMIC RETICULUM. It consists of a group of regulatory cascades that are triggered as a response to altered levels of calcium and/or the redox state of the endoplasmic reticulum. Persistent activation of the unfolded protein response leads to the induction of APOPTOSIS.
Labor Onset
The beginning of true OBSTETRIC LABOR which is characterized by the cyclic uterine contractions of increasing frequency, duration, and strength causing CERVICAL DILATATION to begin (LABOR STAGE, FIRST ).
Labor, Obstetric
The repetitive uterine contraction during childbirth which is associated with the progressive dilation of the uterine cervix (CERVIX UTERI). Successful labor results in the expulsion of the FETUS and PLACENTA. Obstetric labor can be spontaneous or induced (LABOR, INDUCED).
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