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Influence of gestational diabetes mellitus on outcomes of preinduced labour with dinoprostone vaginal insert
, 1, 1, 2, 3, 1, 1
Affiliations- Department of Obstetrics & Perinatology, Jagiellonian University Medical College, Cracow, Poland
- Department of Nursing Management and Epidemiological Nursing, Jagiellonian University, Collegium Medicum, Cracow, Poland
- Department of Gynecology and Obstetrics, City Hospital, Rzeszow, Poland
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Abstract
Objectives: The aim of this study was to evaluate the effectiveness of labour preinduction using a dinoprostone vaginal insert in patients with gestational diabetes mellitus versus patients undergoing labour induction for other causes. The second aim of the study was to compare perinatal outcomes in both groups.
Material and methods: The study has a retrospective character, conducted in 2019–2021 in a tertiary reference hospital. The following endpoints were assumed for the analysis: natural childbirth, birth occurring within 12 hours of dinoprostone administration and neonatal outcomes. Furthermore, indications of a caesarean section were analysed.
Results: The percentage of natural childbirths was similar in both groups. Furthermore, in both groups, over 80% of patients gave birth within less than 12 hours following dinoprostone administration. Neonatal outcomes (body weight, Apgar score) did not differ statistically. Analysing indications for a caesarean section, failure in the progress of labour was an indication in 39.5% of cases in the control group, 29.4% of cases in gestational diabetes mellitus (GDM), and 50% of cases in diabetes mellitus (DM). The risk of foetal asphyxia was an indication in 55.8% of cases in the control group, 35.3% of cases in GDM and 50% of cases in DM. Ineffective labour induction — no induction of the contractile function was an indication for a C-section in 4.7% of cases in the control group and 35.3% of cases in GDM; no cases were noted in DM (p = 0.024).
Conclusions: The study demonstrated that patients undergoing labour induction due to GDM using a dinoprostone vaginal insert did not differ in terms of labour duration, oxytocin administration compared to patients undergoing labour induction for other causes. Furthermore, the same rate of caesarean sections was found in the study group; however, these groups differ in terms of indications, including risk of foetal asphyxia (35.3% vs 55.8%), failure in the progress of labour (29.4% vs 39.5%), and no active labour (1.8% vs 1.5%). The neonatal Apgar score at 1.5 and 10 minutes after birth was similar in both groups.
Abstract
Objectives: The aim of this study was to evaluate the effectiveness of labour preinduction using a dinoprostone vaginal insert in patients with gestational diabetes mellitus versus patients undergoing labour induction for other causes. The second aim of the study was to compare perinatal outcomes in both groups.
Material and methods: The study has a retrospective character, conducted in 2019–2021 in a tertiary reference hospital. The following endpoints were assumed for the analysis: natural childbirth, birth occurring within 12 hours of dinoprostone administration and neonatal outcomes. Furthermore, indications of a caesarean section were analysed.
Results: The percentage of natural childbirths was similar in both groups. Furthermore, in both groups, over 80% of patients gave birth within less than 12 hours following dinoprostone administration. Neonatal outcomes (body weight, Apgar score) did not differ statistically. Analysing indications for a caesarean section, failure in the progress of labour was an indication in 39.5% of cases in the control group, 29.4% of cases in gestational diabetes mellitus (GDM), and 50% of cases in diabetes mellitus (DM). The risk of foetal asphyxia was an indication in 55.8% of cases in the control group, 35.3% of cases in GDM and 50% of cases in DM. Ineffective labour induction — no induction of the contractile function was an indication for a C-section in 4.7% of cases in the control group and 35.3% of cases in GDM; no cases were noted in DM (p = 0.024).
Conclusions: The study demonstrated that patients undergoing labour induction due to GDM using a dinoprostone vaginal insert did not differ in terms of labour duration, oxytocin administration compared to patients undergoing labour induction for other causes. Furthermore, the same rate of caesarean sections was found in the study group; however, these groups differ in terms of indications, including risk of foetal asphyxia (35.3% vs 55.8%), failure in the progress of labour (29.4% vs 39.5%), and no active labour (1.8% vs 1.5%). The neonatal Apgar score at 1.5 and 10 minutes after birth was similar in both groups.
Keywords
dinoprostone, induction of labor, gestational diabetes mellitus, GDM, cesarean delivery
About this articleTitle
Influence of gestational diabetes mellitus on outcomes of preinduced labour with dinoprostone vaginal insert
Journal
Issue
Article type
Research paper
Pages
539-543
Published online
2023-03-27
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1210
Article views/downloads
312
DOI
Pubmed
Bibliographic record
Ginekol Pol 2023;94(7):539-543.
Keywords
dinoprostone
induction of labor
gestational diabetes mellitus
GDM
cesarean delivery
Authors
Magdalena Kolak
Katarzyna Skibinska
Magda Rybak-Krzyszkowska
Agnieszka Micek
Tomasz Gora
Hubert Huras
Andrzej P. Jaworowski
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