COMPARISON OF DINOPROSTONE PLUS OXYTOCIN AND OXYTOCIN ALONE FOR INDUCTION OF LABOR

Role of labor induction has increased in the last decade due to the early detection of fetaljeopardy. although very useful, oxytocin alone is not always successful for induction of labor. in arandomized clinical trial we compared vaginal dinoprostone plus oxytocin with oxytocin alone forinduction of labor in 91 pregnant women at 40 weeks or greater gestation with bishop scores ،ـ 4. fortysix patients assigned to the dinoprostone group received 3 mg intravaginal dinoprostone. six hours laterthe bishop score was evaluated and if the patient had not at least 3 contractions in 10 minutes lasting formore than 40 seconds, intravenous oxytocin was started at a dose of 6 mu/min and increased by 6mu/min at 40 minute intervals until adequate uterine activity. forty five patients assigned to theoxytocin group underwent oxytocin induction from the start of labor induction. although the bishopscore change after 6 hours of receiving vaginal dinoprostone from 2.54 to 4.97 was statisticallysignificant, the oxytocin only group had a much better response with a change from 2.60 to 6.28.median time between induction to the start of active labor was significantly shorter in the oxytocinalone group (p = 0.04). median time between induction to delivery and the rate of cesarean did notdiffer significantly in these groups (p > 0.05). it was concluded that single dose of dinoprostone iseffective for initiating labor in patients with an unfavorable cervix and appears safe but it is not aseffective as oxytocin.