Vaginal Dinoprostone Effective for Labor Induction in Term PROM

Premature rupture of membranes (PROM) at term, in the absence of spontaneous uterine contractions, poses potential risks for both mother and fetus. When amniotic fluid leakage is prolonged, timely labor induction becomes necessary. The challenge is greater in women with unfavorable cervical conditions, defined by a Bishop score <6.

A recent study evaluated 81 cases of term PROM with low Bishop scores, where labor was induced using a vaginal dinoprostone insert. All patients were otherwise healthy with no significant obstetric or medical complications. The mean neonatal birth weight was 3,293 g, and 98% of neonates had Apgar scores ≥8 (only one had an Apgar score of 6).

Vaginal delivery was achieved in 65% of cases, with an additional 8% requiring vacuum-assisted delivery. Cesarean section was performed in 26% of patients, primarily due to failed induction or suspected intrauterine infection.

The findings suggest that vaginal administration of dinoprostone is a safe and effective option for inducing labor in term PROM cases with an unfavorable cervix.

Source:Zwoliński J, Śladowska-Zwolińska A, Siergiej M, et al. European Journal of Obstetrics and Gynecology and Reproductive Biology. 2024 Feb 1;293:110.