Predictors of vaginal delivery after cervical ripening using a synthetic osmotic dilator

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00216224%3A14110%2F20%3A00115800" target="_blank" >RIV/00216224:14110/20:00115800 - isvavai.cz</a>

Nalezeny alternativní kódy

RIV/65269705:_____/20:00072758

Výsledek na webu

<a href="https://www.sciencedirect.com/science/article/pii/S0301211520300579?via%3Dihub" target="_blank" >https://www.sciencedirect.com/science/article/pii/S0301211520300579?via%3Dihub</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1016/j.ejogrb.2020.01.048" target="_blank" >10.1016/j.ejogrb.2020.01.048</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Predictors of vaginal delivery after cervical ripening using a synthetic osmotic dilator

Popis výsledku v původním jazyce

Objective: To evaluate the determinants of vaginal delivery and safety in women undergoing cervical ripening with a synthetic osmotic dilator (Dilapan-S) prior to induction of labor. Methods: We conducted a secondary analysis of an international multicenter prospective observational study of Dilapan-S for cervical ripening in pregnancies greater than 32 weeks. Data were obtained in a standardized fashion and entered into a centralized electronic data capture system. The association between Bishop score and vaginal delivery was further evaluated with a multivariate receiver-operating characteristic (ROC) curve analysis. A Wilcoxon rank test and multivariable logistic regression were used for statistical analysis (significance: P &lt; .05). Results: Between May 2015 and July 2016, 444 pregnant women were included. Three hundred ten (70 %) delivered vaginally. Compared to patients who underwent cesarean delivery, those who delivered vaginally were more likely to have a history of prior vaginal delivery. Vaginal delivery rates were significantly correlated with Bishop scores of pre and post Dilapan-S and difference. After adjusting for age, BMI, number of dilators, cervical ripening time, and gestational age, both prior vaginal delivery and post-Dilapan-S Bishop scores were strong predictors of vaginal delivery (estimate coefficient: 0.1275 +/- 0.03 P = .0002; 0.049 +/- 0.01 P = .0001; respectively). Aggregate ROC accounting for these variables further supported these findings (AUC = 0.734). The lower confidence interval limit of vaginal delivery rates was above 50 % when post-Dilapan-S Bishop scores were &gt;= 5. Cox regression analyses demonstrated that the duration of labor was significant shorter in women that had vaginal delivery. Conclusion: Bishop scores after cervical ripening with Dilapan-S are good predictors of vaginal delivery. Bishop scores &lt; 5 post Dilapan-S may warrant further cervical ripening. Further level 1 trials are needed to compare osmotic dilators to other ripening methods. (C) 2020 Elsevier B.V. All rights reserved.

Název v anglickém jazyce

Predictors of vaginal delivery after cervical ripening using a synthetic osmotic dilator

Popis výsledku anglicky

Objective: To evaluate the determinants of vaginal delivery and safety in women undergoing cervical ripening with a synthetic osmotic dilator (Dilapan-S) prior to induction of labor. Methods: We conducted a secondary analysis of an international multicenter prospective observational study of Dilapan-S for cervical ripening in pregnancies greater than 32 weeks. Data were obtained in a standardized fashion and entered into a centralized electronic data capture system. The association between Bishop score and vaginal delivery was further evaluated with a multivariate receiver-operating characteristic (ROC) curve analysis. A Wilcoxon rank test and multivariable logistic regression were used for statistical analysis (significance: P &lt; .05). Results: Between May 2015 and July 2016, 444 pregnant women were included. Three hundred ten (70 %) delivered vaginally. Compared to patients who underwent cesarean delivery, those who delivered vaginally were more likely to have a history of prior vaginal delivery. Vaginal delivery rates were significantly correlated with Bishop scores of pre and post Dilapan-S and difference. After adjusting for age, BMI, number of dilators, cervical ripening time, and gestational age, both prior vaginal delivery and post-Dilapan-S Bishop scores were strong predictors of vaginal delivery (estimate coefficient: 0.1275 +/- 0.03 P = .0002; 0.049 +/- 0.01 P = .0001; respectively). Aggregate ROC accounting for these variables further supported these findings (AUC = 0.734). The lower confidence interval limit of vaginal delivery rates was above 50 % when post-Dilapan-S Bishop scores were &gt;= 5. Cox regression analyses demonstrated that the duration of labor was significant shorter in women that had vaginal delivery. Conclusion: Bishop scores after cervical ripening with Dilapan-S are good predictors of vaginal delivery. Bishop scores &lt; 5 post Dilapan-S may warrant further cervical ripening. Further level 1 trials are needed to compare osmotic dilators to other ripening methods. (C) 2020 Elsevier B.V. All rights reserved.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30214 - Obstetrics and gynaecology

Projekt

—

Návaznosti

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2020

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

EUROPEAN JOURNAL OF OBSTETRICS &amp; GYNECOLOGY AND REPRODUCTIVE BIOLOGY

ISSN

0301-2115

e-ISSN

1872-7654

Svazek periodika

246

Číslo periodika v rámci svazku

March 2020

Stát vydavatele periodika

NL - Nizozemsko

Počet stran výsledku

5

Strana od-do

160-164

Kód UT WoS článku

000518494100029

EID výsledku v databázi Scopus

2-s2.0-85078792051