Objective: To evaluate the association between repeated doses of vaginal PGE2 and the maternal and neonatal outcomes for primigravid and multiparous women. Study design: A retrospective descriptive study was conducted at a teaching university hospital in Jordan. The study involved 885 women with singleton live fetuses; these women had been admitted to the labor ward for an induction of labor by vaginal PGE2 (Dinoprostone, Prostin®) for different indications from January 2015 to December 2016. The women were classified according to parity into two main groups, namely, primigravid and multiparous. In the primigravid group, the women who had received two or fewer doses of a vaginal PGE2 tablet (3 mg Dinoprostone) were compared with those who had received a PGE2 tablet three times. In the multiparous group, the women who had received one or two doses of half the usual vaginal PGE2 tablet (1.5 mg Dinoprostone) were compared with those who had received the same dose three times. The main outcomes studied were the cesarean section rate and the APGAR score. Results: There was a statistically significant association, namely, X2 (1) = 13.96, P = 0.001, between the repeated doses of PGE2 and the mode of delivery. This indicates that primigravid women who received more than two doses of PGE2 were more likely to have a cesarean section (65.5%, n = 57 out of 87) compared with primigravid women who received two or fewer doses of PGE2 (42.9%, n = 132 out of 308). There was no significant association between repeated doses of PGE2 insertion and admission either to the nursery or the neonatal intensive care unit (NICU) X2 (1) = 2.11, P = 0.14. Moreover, the results also showed that there was no significant association between repeated doses of PGE2 insertion and the APGAR score X2 (1) = 0.06, P = 0.88. For multiparous women, there was no statistically significant association X2 (1) = 2.15, P = 0.14 between repeated doses of PGE2 insertion and the mode of delivery. Conclusion: In both groups of primigravid and multiparous women, the third dose of vaginal PGE2 was not associated with a significant increase in maternal or neonatal morbidity. In the primigravid group, despite the third dose of PGE2 being associated with a higher rate of cesarean section in comparison with two or fewer doses of it, nearly a third of the women nevertheless achieved vaginal delivery. In the multiparous group, the third dose of PGE2 was not associated with a higher rate of cesarean sections.
Cite this article
Volume | Year
Open Access Original Research
The association between repeated doses of vaginal PGE2 (Dinoprostone, Prostin®) and both maternal and neonatal outcomes among women in the north of Jordan
A.M. Sindiani1,*, H.M. Rawashdeh1, E.H. Alshdaifat1,2, O.F. Altal1, H. Yaseen1, A.A. Alhowary3
1 Department of Obstetrics and Gynecology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
2 Department of Obstetrics and Gynecology, Faculty of Medicine, Yarmouk University, Irbid, Jordan
3 Department of Anaesthesia, Jordan University of Science and Technology, Irbid, Jordan
*Correspondence: firstname.lastname@example.org (AMER MAHMOUD SINDIANI)
Clin. Exp. Obstet. Gynecol. 2020, 47(3), 329–334; https://doi.org/10.31083/j.ceog.2020.03.5322
Submitted: 12 July 2019 | Accepted: 30 October 2019 | Published: 15 June 2020
Copyright: © 2020 Sindiani et al. Published by IMR press.
This is an open access article under the CC BY 4.0 license
49/116/2018/Jordan University of Science and Technology/King Abdullah University Hospital