Dersleri yüzünden oldukça stresli bir ruh haline sikiş hikayeleri bürünüp özel matematik dersinden önce rahatlayabilmek için amatör pornolar kendisini yatak odasına kapatan genç adam telefonundan porno resimleri açtığı porno filmini keyifle seyir ederek yatağını mobil porno okşar ruh dinlendirici olduğunu iddia ettikleri özel sex resim bir masaj salonunda çalışan genç masör hem sağlık hem de huzur sikiş için gelip masaj yaptıracak olan kadını gördüğünde porn nutku tutulur tüm gün boyu seksi lezbiyenleri sikiş dikizleyerek onları en savunmasız anlarında fotoğraflayan azılı erkek lavaboya geçerek fotoğraflara bakıp koca yarağını keyifle okşamaya başlar
Reach Us +44 3308186230

GET THE APP

The Effect of Parity on Labor Induction with Prostaglandin E2 Analogue (Dinoprostone): An Evaluation of 2090 Cases | OMICS International | Abstract

Our Group organises 3000+ Global Conferenceseries Events every year across USA, Europe & Asia with support from 1000 more scientific Societies and Publishes 700+ Open Access Journals which contains over 50000 eminent personalities, reputed scientists as editorial board members.

Open Access Journals gaining more Readers and Citations
700 Journals and 15,000,000 Readers Each Journal is getting 25,000+ Readers

This Readership is 10 times more when compared to other Subscription Journals (Source: Google Analytics)

Research Article

The Effect of Parity on Labor Induction with Prostaglandin E2 Analogue (Dinoprostone): An Evaluation of 2090 Cases

Omer Kandemir*, Hulya Dede, Serdar Yalvac, Oya Aldemir, Bulent Yirci, Neslihan Yerebasmaz and Sertac Esin
Etlik Zubeyde Hanim Womens’ Health and Teaching Hospital, Department of Maternal Fetal Medicine, Ankara, Turkey
Corresponding Author : Omer Kandemir
Etlik Zubeyde Hanim Womens’ Health and Teaching Hospital
Department of Maternal Fetal Medicine, Ankara, Turkey
Tel: +90 312 5674334
Fax: +90 312 238 1819
E-mail:omer.kandemir@gmail.com
Received March 16, 2015; Accepted April 13, 2015; Published April 15, 2015
Citation: Kandemir O, Dede H, Yalvac S, Aldemir O, Yirci B, et al. (2015) The Effect of Parity on Labor Induction with Prostaglandin E2 Analogue (Dinoprostone): An Evaluation of 2090 Cases. J Preg Child Health 2:149. doi: 10.4172/2376-127X.1000149
Copyright: © 2015 Kandemir O, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Objective: The aim of this study was to investigate the effect of parity on cervical ripening and labor induction with intra-vaginal slow-release dinoprostone and to determine the safety and efficacy of this medication in a tertiary referral center.

Methods: The medical records of 2090 pregnant women who underwent cervical ripening and induction of labor with Dinoprostone between January 2007 and December 2010 were retrospectively reviewed. All women included in the study had singleton pregnancies greater than 37 gestational weeks and the Bishop score was less than 4. Our induction of labor policy was to use dinoprostone for patients <35 years old and low parity (≤ 2). Ten milligram of intravaginal slow-release dinoprostone was applied vaginally for 24 hours. Nulliparousand multiparous patient results were compared.

Results: One thousand one hundred seventy two nulliparous and 918 multiparous patients were included in the study. Indications for induction of labor were; post-term pregnancy in 67.2%, oligohydramniosis in 11.8 %, severe intrauterine fetal growth restriction in 9.7%, severe gestational hypertension or chronic hypertension or preeclampsia necessitating delivery in 6.8 %, and premature rupture of membranes in 4.4 %. The mean patient age, gestational age, parity and Bishop Score before induction were 25.22 ± 4.9, 40.21 ± 1.2, 1.6 ± 0.4 and 2.47 ± 0.2, respectively. The induction to active phase, active phase to vaginal delivery and induction to vaginal delivery durations for nulliparous and multiparous groups were (7.5 ± 6.3 vs. 6.8 ± 6.0, p=0.012) and (7.7 ± 5.6 vs. 5.8 ± 5.0, p=0.001) and (15.6 ± 7.7 vs. 13.5 ± 5.4, p=0.023), respectively. The delivery rates during the first 24 hours after application of dinoprostone were 65.7 % and 71.5 % for nulliparous and multiparous patients, respectively (p=0,001). In the nulliparous group, the change in Bishop Score was significantly higher than the multiparous patient group (p=0.034). During labor, 31.1% of the patients needed oxytocin augmentation and this was 34.9% in the nulliparous and 26.4% in the multiparous groups (p=0.001). The cesarean delivery rate was higher in the nulliparous group (34.3% vs. 24.9%, p=0.002). The percentage of newborns with 5-minute Apgar scores less than 7 and the percentage of newborns requiring neonatal intensive care unit (NICU) were similar between nulliparous and multiparous groups.

Conclusion: Dinoprostone seems to be an effective agent for induction of labor in patients with an unfavorable cervix for patients <35 years old and with low parity (≤ 2). The induction to vaginal delivery duration is shorter and delivery rate in the first 24 hours is higher in multiparous group. The perinatal outcomes are comparable between groups.

Keywords

Top