Comparing Dinoprostone and Oxytocin for labor induction in pregnancies ≥ 37 weeks with prelabor rupture of membranes at Hung Vuong Hospital

Tóm tắt

   Background: Prelabor rupture of membranes (PROM) at term is associated with increased maternal and neonatal infection risks, and induction of labor (IOL) is recommended to improve pregnancy outcomes. Dinoprostone and oxytocin are commonly used for IOL; however, direct comparative evidence in Vietnam remains limited.
   Methods: This retrospective cohort study included 140 term pregnant women (≥ 37 weeks’ gestation) with PROM who underwent IOL at Hung Vuong Hospital between January 2023 and February 2025. Seventy women were assigned to each group dinoprostone and oxytocin. The primary outcome was successful IOL, defined as achieving a Bishop score ≥ 7 or entering active labor (cervical dilation ≥ 4 cm) within 24 hours. Secondary outcomes included mode of delivery, induction-to-delivery interval, and maternal and neonatal outcomes. Multivariable regression models were used to adjust for potential confounders.
   Results: The overall successful IOL rate was 73.6% (95% CI, 65.5-80.7). After adjustment for parity and Bishop score, there was no significant difference in IOL success between the oxytocin and dinoprostone groups (adjusted RR = 1.21; 95% CI, 0.99-1.47). The vaginal delivery rate was higher in the oxytocin group than in the dinoprostone group (64.3%, 95% CI 51.9-75.4 vs 40.0%, 95% CI 28.4-52.4); and oxytocin was independently associated with a higher likelihood of vaginal delivery (adjusted RR = 1.47; 95% CI, 1.05-2.06). Dinoprostone was associated with a shorter induction-to-delivery interval, mainly due to a shorter time from treatment initiation to successful IOL (HR = 1.96; 95% CI, 1.29-2.99). Maternal complications were uncommon and neonatal outcomes were comparable between groups.
   Conclusions: In term pregnancies with PROM, dinoprostone and oxytocin showed comparable effectiveness and safety for achieving successful IOL. Oxytocin was associated with a higher likelihood of vaginal delivery, whereas dinoprostone was associated with a shorter induction duration. However, the retrospective design and single-center setting may limit causal inference and generalizability of the findings. These results support individualized selection of induction methods based on clinical context.

DOI: 10.59715/pntjmp.5.2.18