Comparison between Oxytocin and Dinoprostone in Labor Induction in Pregnancies with Premature Rupture of Membranes

Background: Premature membrane rupture (PROM) remains one of the most difficult issues in obstetrics because of the increased morbidity and mortality of both mothers and fetuses. Several studies have looked at the best management techniques for these circumstances. Objective: This study aimed to compare between two protocols (oxytocin versus sustained release dinoprostone followed six hours later by oxytocin) for induction of labor in pregnancies with premature rupture of membranes at term. Patients and Methods: This prospective comparative study was conducted at Ain Shams Maternity Hospital and Obstetrics and Gynecology Department at El-Sahel Teaching Hospital during the period between May 2013 and August 2014. This study included 90 pregnant women with premature rapture of membranes at term (37-42 weeks of gestation, as determined by first day of LMP or by 1^st or 3nd trimester ultrasound scan).
Results: Vaginal delivery within 24 hours of labor induction was significantly increased in dinoprostone-oxytocin group than oxytocin. (66.7% for oxytocin group vs. 80% for dinoprostone followed by oxytocin). Also, more cesarean sections were performed in the oxytocin group (33.3% for oxytocin group vs. 20% for dinoprostone-oxytocin group). Mean induction active phase and induction delivery intervals were significantly shorter in oxytocin group than dinoprostone-oxytocin group. Conclusion: With a significant increase in the rate of vaginal delivery within 24 hours in comparison with oxytocin alone and shorter induction active phase and induction delivery intervals in the oxytocin group than in the dinoprostone-oxytocin group. Sustained release dinoprostone followed by oxytocin six hours later is an alternative safe method for inducing labour in women with term PROM. There is no distinction between the two groups in terms of maternal and newborn outcomes.