Home cervical ripening with dinoprostone gel in nulliparous women with singleton pregnancies

Sarah J Stock, Rebecca Taylor, Rebecca Mairs, Abdulhamid Azaghdani, Kahyee Hor, Imogen Smith, Kirsty Dundas, Chris Kissack, Jane E Norman, Fiona Denison

Research output: Contribution to journalArticle (Academic Journal)peer-review

7 Citations (Scopus)

Abstract

OBJECTIVE: To evaluate whether home cervical ripening is safe and results in shorter hospital stay.

METHODS: This was a retrospective cohort study of women with singleton pregnancies having induction of labor for postmaturity at a single center between January 2007 and June 2010. Women were offered home cervical ripening with 1 mg dinoprostone gel if they were nulliparous, had uncomplicated singleton pregnancies, and the indication for induction was postmaturity.

RESULTS: Nine hundred seven of 1,536 (59.1%) nulliparous women having induction of labor for postmaturity were eligible for home cervical ripening. The median number of hours at home was 11.76 hours (range 0-24.82 hours). There were no cases of birth outside of the hospital, uterine rupture, or significant neonatal morbidity or neonatal death related to home cervical ripening. Eighty-five (5.5%) women who underwent hospital cervical ripening because of maternal preference or social issues formed a hospital cervical ripening comparison group. There was no significant difference in the total number of hours before delivery spent in the hospital between the two groups (26.25; 95% confidence interval [CI] 25.27-27.23 in home cervical ripening group compared with 24.28; 95% CI 22.5-26.0 in the hospital group; P=.26).

CONCLUSIONS: Clinical outcomes are comparable in nulliparous women who receive a single dose of dinoprostone gel for home cervical ripening compared with those who undergo hospital cervical ripening. However, preadmission home cervical ripening with 1 mg dinoprostone does not decrease the number of hours women spend in the hospital.

LEVEL OF EVIDENCE: II.

Original languageEnglish
Pages (from-to)354-60
Number of pages7
JournalObstetrics and Gynecology
Volume124
Issue number2 Pt 1
DOIs
Publication statusPublished - Aug 2014

Keywords

  • Adult
  • Cervical Ripening
  • Dinoprostone/adverse effects
  • Female
  • Gels
  • Humans
  • Length of Stay
  • Oxytocics/adverse effects
  • Parity
  • Pregnancy
  • Retrospective Studies
  • Self Administration/adverse effects
  • Time Factors

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