Journal of Postgraduate Medicine, Education and Research

Register      Login

VOLUME 53 , ISSUE 2 ( April-June, 2019 ) > List of Articles

Original Article

Effect of Vaginal pH on Efficacy of the Dinoprostone Gel on Labor Induction and Outcomes

Aruna Kumari, Suman L Sharma, Anita Pal, Vikas Bhatia

Keywords : Dinoprostone, Induction of labor, Pregnancy, Vaginal pH

Citation Information : Kumari A, Sharma SL, Pal A, Bhatia V. Effect of Vaginal pH on Efficacy of the Dinoprostone Gel on Labor Induction and Outcomes. J Postgrad Med Edu Res 2019; 53 (2):72-74.

DOI: 10.5005/jp-journals-10028-1316

License: CC BY-NC 4.0

Published Online: 01-08-2011

Copyright Statement:  Copyright © 2019; The Author(s).


Abstract

Aim: To study the effect of vaginal pH on the efficacy of the dinoprostone gel for cervical ripening/labor induction and the effect on fetal and maternal outcomes. Methods: A prospective study over one year was conducted and all term pregnancies with induced labor and who satisfied the inclusion criteria were screened for enrollment. Total of 500 subjects was enrolled in this study. These subjects were divided into two groups, group I (pH <5.5) had 199 subjects, group II (pH ≥5.5) had 301 subjects. Results: Overall delivery outcome was better in group II (pH ≥5.5) as compared to group I (pH<5.5). Mean bishop score changes (over 12 hours) were also better in group II. Similarly, the need for the second dose, mean duration from induction to active labor and delivery was less, more subjects delivered vaginally, in group II (pH ≥5.5) as compared to group I. Conclusion: Vaginal pH appears to be one important factor that influences the efficacy of PGE2 gel, results being better with high pH (pH ≥5.5).


PDF Share
  1. Hayashi RH. Spontaneous and induced cervical ripening: natural dilation and effacement process and current cervical ripening techniques. J Reprod Med 1993;38:66-72.
  2. Trofatter KF. Cervical ripening. Clin Obstet Gynecol 1992;35:476-486.
  3. Keirse MJNC. Prostaglandins in preinduction cervical ripening: metaanalysis of worldwide clinical experience. J Reprod Med 1993;38:89-100
  4. Theobald PW, Rath W, Kuhnle H, Kuhn W. Histological and electronmicroscopic examinations of collagenous connective tissue of the non-pregnant cervix, the pregnant cervix, and the pregnant prostaglandin-treated cervix. Arch Gynecol 1982;231:241-245.
  5. Uldbjerg N, Ekman G, Malmström A, et al. Biochemical changes in human cervical connective tissue after local application of prostaglandin E2. Gynecol Obstet Invest 1983;15:291-299.
  6. Johnson TA, Greer IA, Kelly RW, et al. The effect of pH on release of PGE2 from vaginal and endocervical preparations for induction of labour: an in-vitro study. Br J Obstet Gynaecol 1992;99:877-880.
  7. MacDonald IA, Weir RF. The effect of pH on release of PGE2 from vaginal and endocervical preparations for induction of labour. Br J Obstet Gynaecol 1993;100:1066-1067.
  8. Lyrenas S, Clason I, Ulmsten U. In vivo controlled release of PGE2 from a vaginal insert (0.8 mm, 10 mg) during induction oflabour. Br J Obstet Gynaecol 2001;108:169-178.
  9. Ramsey PS, Ogburn PL Jr, Harris DY, et al. Effect of vaginal pH on efficacy of controlled release dinoprost gel on labour induction/ cervical ripening. J Matern Fetal Neonatal Med. 2003 Apr;13(4): 250-253.
  10. Singh U, Malhrotra S, Gupta HP, et al. A prospective double blind trial investigating impact of vaginal pH on efficacy of dinoprost gel for cervical ripening and course of labour. J Obstet Gynaecol 2011;31 (3):217-219.
  11. Onen S, Ozaksit G, Yilmaz B, et al. The role of vaginal pH on efficacy of controlled release dinoprostone vaginal insert for cervical ripening/ labour induction: A prospective double blind study. Journal of the Turkish German Gynecological Association 2008;9:206-211.
  12. Raza F, Majeed S. Intracervical PGE2 GEL for Cervical Ripening and Induction of Labour. Pak J Med Sci April 2008;24 (2):241-245.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.