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• W2090544265 abstract "ObjectiveTo compare sequential dinoprostone and oxytocin for induction of labor at term with intact membranes to two simultaneous regimens. Our aim was to confirm earlier findings from smaller trials and add to the data on fetal safety.Study designWe performed a non-blinded, three arm randomized trial at 3 sites. Entry criteria were: ≥36 weeks' singleton, cephalic gestation with intact membranes and an unripe cervix (Bishop's score ≤6). Study arms were: 1) dinoprostone vaginal insert for 12 hours followed by oxytocin, 2) dinoprostone vaginal insert for 12 hours with simultaneous oxytocin, and 3) intracervical dinoprostone gel (one dose) followed by immediate oxytocin. Primary outcome measure was the rate of vaginal delivery <24 hours. Secondary outcomes were randomization to delivery interval, rate of cesarean delivery (CD) for non reassuring fetal status (NRFS) and rate of hyperstimulation.Results217 patients were recruited (75, 68 and 73 for the 3 arms seen above respectively, one withdrew after randomization). There was no significant difference in vaginal delivery <24 hours (38.6%, 42.6% and 46.6% for 3 arms respectively, p=0.62), in randomization to delivery interval (mean minutes 1375+811, 1140+728 and 1098+413, p=0.12 and range 337-4625, 327-3745, 420-2241 for the 3 arms respectively) and in CD for NRFS (6.7%, 16.2% and 17.8% for 3 arms respectively, p=0.10). Analysis of 48 patients showed no difference in the rate of hyperstimulation. The randomization to delivery interval standard deviation for study arm 3 was significantly less than the other groups (p=0.00001) by Fisher's F test.ConclusionWe found no difference in vaginal delivery <24 hours, randomization to delivery interval, CD for NRFS and hyperstimulation when comparing simultaneous versus sequential dinoprostone and oxytocin for induction of labor at term with an unripe cervix. The smaller standard deviation and range for the induction to delivery interval for simultaneous intracervical dinoprostone gel and intravenous oxytocin suggests a more efficient timing of delivery for busy labor units. ObjectiveTo compare sequential dinoprostone and oxytocin for induction of labor at term with intact membranes to two simultaneous regimens. Our aim was to confirm earlier findings from smaller trials and add to the data on fetal safety. To compare sequential dinoprostone and oxytocin for induction of labor at term with intact membranes to two simultaneous regimens. Our aim was to confirm earlier findings from smaller trials and add to the data on fetal safety. Study designWe performed a non-blinded, three arm randomized trial at 3 sites. Entry criteria were: ≥36 weeks' singleton, cephalic gestation with intact membranes and an unripe cervix (Bishop's score ≤6). Study arms were: 1) dinoprostone vaginal insert for 12 hours followed by oxytocin, 2) dinoprostone vaginal insert for 12 hours with simultaneous oxytocin, and 3) intracervical dinoprostone gel (one dose) followed by immediate oxytocin. Primary outcome measure was the rate of vaginal delivery <24 hours. Secondary outcomes were randomization to delivery interval, rate of cesarean delivery (CD) for non reassuring fetal status (NRFS) and rate of hyperstimulation. We performed a non-blinded, three arm randomized trial at 3 sites. Entry criteria were: ≥36 weeks' singleton, cephalic gestation with intact membranes and an unripe cervix (Bishop's score ≤6). Study arms were: 1) dinoprostone vaginal insert for 12 hours followed by oxytocin, 2) dinoprostone vaginal insert for 12 hours with simultaneous oxytocin, and 3) intracervical dinoprostone gel (one dose) followed by immediate oxytocin. Primary outcome measure was the rate of vaginal delivery <24 hours. Secondary outcomes were randomization to delivery interval, rate of cesarean delivery (CD) for non reassuring fetal status (NRFS) and rate of hyperstimulation. Results217 patients were recruited (75, 68 and 73 for the 3 arms seen above respectively, one withdrew after randomization). There was no significant difference in vaginal delivery <24 hours (38.6%, 42.6% and 46.6% for 3 arms respectively, p=0.62), in randomization to delivery interval (mean minutes 1375+811, 1140+728 and 1098+413, p=0.12 and range 337-4625, 327-3745, 420-2241 for the 3 arms respectively) and in CD for NRFS (6.7%, 16.2% and 17.8% for 3 arms respectively, p=0.10). Analysis of 48 patients showed no difference in the rate of hyperstimulation. The randomization to delivery interval standard deviation for study arm 3 was significantly less than the other groups (p=0.00001) by Fisher's F test. 217 patients were recruited (75, 68 and 73 for the 3 arms seen above respectively, one withdrew after randomization). There was no significant difference in vaginal delivery <24 hours (38.6%, 42.6% and 46.6% for 3 arms respectively, p=0.62), in randomization to delivery interval (mean minutes 1375+811, 1140+728 and 1098+413, p=0.12 and range 337-4625, 327-3745, 420-2241 for the 3 arms respectively) and in CD for NRFS (6.7%, 16.2% and 17.8% for 3 arms respectively, p=0.10). Analysis of 48 patients showed no difference in the rate of hyperstimulation. The randomization to delivery interval standard deviation for study arm 3 was significantly less than the other groups (p=0.00001) by Fisher's F test. ConclusionWe found no difference in vaginal delivery <24 hours, randomization to delivery interval, CD for NRFS and hyperstimulation when comparing simultaneous versus sequential dinoprostone and oxytocin for induction of labor at term with an unripe cervix. The smaller standard deviation and range for the induction to delivery interval for simultaneous intracervical dinoprostone gel and intravenous oxytocin suggests a more efficient timing of delivery for busy labor units. We found no difference in vaginal delivery <24 hours, randomization to delivery interval, CD for NRFS and hyperstimulation when comparing simultaneous versus sequential dinoprostone and oxytocin for induction of labor at term with an unripe cervix. The smaller standard deviation and range for the induction to delivery interval for simultaneous intracervical dinoprostone gel and intravenous oxytocin suggests a more efficient timing of delivery for busy labor units." @default.
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• W2090544265 date "2006-12-01" @default.
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• W2090544265 title "Simultaneous versus sequential dinoprostone and oxytocin for induction of labor at term with intact membranes: A three arm randomized controlled trial" @default.
• W2090544265 doi "https://doi.org/10.1016/j.ajog.2006.10.297" @default.
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