ArticleCureus2025
The Effect of Introducing Dinoprostone Vaginal Inserts (DVI) in Cases of Term Prelabor Rupture of Membranes With Unfavorable Cervix.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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5 authors.
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Abstract
aimTo evaluate the efficacy and safety of dinoprostone vaginal inserts (DVI) for labor induction in women with term prelabor rupture of membranes (PROM) and an unfavorable cervix.
methodsThis retrospective, single-center observational study included singleton, cephalic pregnancies at ≥37 weeks' gestation admitted for PROM (August 2017-December 2024). Exclusion criteria were spontaneous labor onset, cesarean delivery without induction, or a Simplified Bishop score (SBS) ≥6. Prior to DVI availability (2017-2020), intravenous oxytocin administration was performed in all cases; after 2020, DVI was administered when SBS ≤5, followed by oxytocin as needed. Sixty matched cases per group were analyzed following propensity score matching for maternal age, height, weight at delivery, and SBS. Primary outcomes included vaginal delivery rate, labor duration, and oxytocin use; secondary outcomes included chorioamnionitis, postpartum hemorrhage, and neonatal morbidity.
resultsVaginal delivery rates were comparable (DVI 78.3% vs. oxytocin 73.3%, p = 0.52). Median time from PROM to delivery was similar (DVI 47.0 h vs. oxytocin 51.9 h). Oxytocin use was significantly lower in the DVI group (46.7% vs. 100%, p < 0.0001). No significant differences were observed in chorioamnionitis or neonatal outcomes. Among vaginal deliveries, more women in the DVI group delivered within 24 or 48 hours, although this difference was not statistically significant.
conclusionIn PROM with an unfavorable cervix, DVI use did not increase adverse outcomes and was associated with reduced oxytocin use. While differences in delivery timing were not statistically significant, DVI may provide clinical benefits, supporting the need for further prospective studies.
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