Objective: To validate a mathematical model to predict the mean time to delivery (TTD) following cervical ripening with dinoprostone vaginal insert (DVI), and assess its impact on the risk of nocturnal deliveries.
Methods: We performed a case-control retro-prospective study at Angers University Hospital. In the control group, we retrospectively included 405 patients who underwent cervical ripening with DVI between 01/2015 and 09/2016. Based on the delivery outcomes, we developed a mathematical model that integrates all the factors influencing TTD following cervical ripening with DVI. In the study group, we prospectively included 223 patients who underwent cervical ripening with DVI between 11/2017 and 11/2018. The timing of insertion was calculated using the mathematical model developed in the control group, in order to prevent the occurrence of nocturnal deliveries.
Results: The calculated mean TTD was significantly shorter than the real mean TTD (21h46 min ± 3h28 min versus 25h38 min ± 12h10 min, p < 0.001), and for 44% of patients, there was at least 10 h difference between the two. The real TTD (25h38 min ± 12H10 min versus 20h39 min ± 10h49, p < 0.001), and the rate of nocturnal deliveries (30.5% versus 21.2%, p = 0.01) were significantly higher in the study group compared to the control group.
Conclusion: The mathematical model did not help predicting TTD following cervical ripening with DVI, and or reducing the number of nocturnal deliveries.
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http://dx.doi.org/10.1016/j.ejogrb.2021.08.031 | DOI Listing |
Am J Obstet Gynecol MFM
January 2025
Division of Maternal Fetal Medicine, Brigham and Women's Hospital.
Background: As induction of labor increases in the United States, safe, effective outpatient cervical ripening has been explored as a method to decrease the inpatient time burden. The most effective method of outpatient mechanical cervical ripening remains unclear.
Objective: To evaluate if Dilapan-S is non-inferior to cervical balloon for outpatient cervical ripening (CR) based on change in Bishop score.
J Proteome Res
January 2025
NCR Biotech Science Cluster, Regional Centre for Biotechnology, Faridabad 121001, India.
Preterm birth (PTB) refers to the delivery of a baby before the completion of 37 weeks of gestation. It is a significant global health issue with implications for both mothers and neonates. The placenta is a transient organ crucial in the sustenance of pregnancy until parturition; its dysfunction is associated with different adverse pregnancy outcomes, including PTB.
View Article and Find Full Text PDFCureus
December 2024
Obstetrics, Orlando Regional Medical Center, Orlando, USA.
J Pregnancy
December 2024
Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.
Preinduction cervical ripening in previous caesarean pregnancy is limited to intracervical Foley catheter. This study is aimed at finding the vaginal birth rates, improvement of Bishop score, and safety of osmotic dilator (Dilapan-S) among women with previous caesarean pregnancy. We conducted this single-group clinical study after the approval of the institute ethics committee, clinical trial registration, and obtaining informed consent.
View Article and Find Full Text PDFEur J Obstet Gynecol Reprod Biol
December 2024
Dep. Obstetrics and Gynecology, Medical School, University of Lisbon, Portugal; CEAUL - Centro de Estatística e Aplicações, Faculdade de Ciências, Universidade de Lisboa, Portugal.
Objective: To evaluate whether the success rate of oral mifepristone was not inferior to that of Foley balloon catheter for outpatient cervical ripening of term pregnancies, and whether there were differences in side effects for mothers and newborns.
Design: Open-label, non-inferiority randomised controlled trial.
Setting: A tertiary care European university hospital in an urban setting.
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