The role of vaginal ph on efficacy of controlled-release dinoprostone vaginal ınsert for cervical ripening/labor induction: A prospective double-blind study

Yılmaz, Bülent; BİLGE, Ümit; Mollamahmutoglu, Leyla; Gungor, Tayfun; Ozaksit, Gulnur; ÖNEN, Şahin; Süt, Necdet

The role of vaginal ph on efficacy of controlled-release dinoprostone vaginal ınsert for cervical ripening/labor induction: A prospective double-blind study

Şahin ÖNEN, (Dr. Zekai Tahir Burak Kadın Hastalıkları Eğitim ve Araştırma Hastanesi, Ankara, Türkiye)

Gülnur ÖZAKŞİT, (Dr. Zekai Tahir Burak Kadın Hastalıkları Eğitim ve Araştırma Hastanesi, Ankara, Türkiye)

Bülent YILMAZ, (Dr. Zekai Tahir Burak Kadın Hastalıkları Eğitim ve Araştırma Hastanesi, Ankara, Türkiye)

Tayfun GÜNGÖR, (Dr. Zekai Tahir Burak Kadın Hastalıkları Eğitim ve Araştırma Hastanesi, Ankara, Türkiye)

Ümit BİLGE, (Dr. Zekai Tahir Burak Kadın Hastalıkları Eğitim ve Araştırma Hastanesi, Ankara, Türkiye)

Necdet SÜT, (Edirne Üniversitesi, Tıp Fakültesi, Biyoistatistik Anabilim Dalı, Edirne, Türkiye)

Leyla MOLLAMAHMUTOĞLU (Dr. Zekai Tahir Burak Kadın Hastalıkları Eğitim ve Araştırma Hastanesi, Ankara, Türkiye)

Journal of the Turkish-German Gynecological Association

6 0

Yıl: 2008 Cilt: 9 Sayı: 4 Sayfa Aralığı: 206 - 211 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

The role of vaginal ph on efficacy of controlled-release dinoprostone vaginal ınsert for cervical ripening/labor induction: A prospective double-blind study

Öz:

Amaç: Post-term hastalarda servikal olgunlaşma/doğum eylemi indüksiyonu için kontrollü salınan PGE2 vajinal ovülünün etkinliğinde vajinal pH’ın etkisini değerlendirmek. Materyal ve Metot: Uygunsuz servikal skora sahip (Bishop skoru ²6) 63 post-term kadın bu prospektif çift-kör çalışmaya dahil edildi. Bütün hastalar 12 saat boyunca servikal olgunlaşma/doğum eylemi indüksiyonu için sürekli salınımlı dinoproston vajinal ovülü kullandı. Tekrar dozu 24 saat sonra 1 kez uygulandı. Sonuçlar: Düşük vajinal PH’a (²4.5, n=38) sahip kadınlar ile yüksek vajinal pH’a (>4.5, n=25) sahip kadınlar maternal yaş, parite, VK‹, gestasyonel yaş veya başlangıç Bishop skoru açısından benzer bulundular. Bishop skorunda ilk 12 saatte düşük vajinal pH’lı (3.9 3.3) ile yüksek vajinal pH’lı (5.5 3.4) gruplar arasında anlamlı/önemli bir değişiklik (p<0.05) olduğu saptandı. Düşük vajinal Ph ile yüksek vajinal pH’lı gruplar arasında elde edilen karşılaştırma sonucunda aktif doğum eylemi (14.7±17.3 saat; 13.1±9.8 saat), tam dilatasyon (19.6±20.1 saat; 17.1±11.8 saat) ve doğum zamanları (20.0±21.4 saat; 17.6±12.0 saat) bakımından yazılan sıraya göre her bir grubun zaman ve tolerans değerleri elde edildi. Doğrusal regresyon analizi sonucunda vajinal pH ile 12 saatlik Bishop skoru değişimi, aktif doğum eylemi zamanı, tam dilatasyon zamanı ve doğum zamanı arasında anlamlı bir ilişki bulunmadı. Tartışma: Vajinal pH’nın servikal olgunlaşmaya önemli bir etkisi vardır; ancak, uygunsuz serviksi olan post-term hastalarda (doğum eylemi indüksiyonuna doğru giden, sürekli salınımlı dinoproston vajinal ovül kullanan) doğum sonuçlarına etkisi yoktur.

Anahtar Kelime: Hidrojen-iyon konsantrasyonu Çift kör metot Dinoproston İleriye dönük çalışma Uzun etkili ilaçlar Servikal olgunlaşma Vajina Doğum, obstetrik Doğum, uyarılmış

Konular: Kadın Hastalıkları ve Doğum

Servical olgunlaşma/doğum eylemi indüksiyonu için kontrollü salınan dinoproston vajinal ovülünün etkinliğinde vajinal pH’ın rolü: Prospektif çift-kör çalışma

Öz:

Objective: To evaluate if vaginal pH has any effect on the efficacy of controlled-release PGE2 vaginal insert for cervical ripening/labor induction in post-term patients. Materials and Methods: Sixty-three post-term women with unfavorable cervix (Bishop’s score ²6) undergoing labor induction were enrolled in this prospective, double-blinded trial. All patients received sustained-release dinoprostone vaginal insert for cervical ripening/labor induction during 12 hours, repeated dosing one time 24 hours later. Results: Women with a low vaginal pH (²4.5, n=38) and women with a high vaginal pH (>4.5, n=25) were similar in maternal age, parity, body mass index, gestational age or initial Bishop’s score. Bishop’s score change over the initial 12 hours significantly (p<0.05) differed between the low vaginal pH (3.9±3.3) and the high vaginal pH group (5.5±3.4). Time to active labor (14.7±17.3 hrs vs 13.1±9.8 hrs), complete dilation (19.6±20.1 hrs vs 17.1±11.8 hrs) and delivery (20.0±21.4 hrs vs 17.6±12.0 hrs) were comparable between the low and high vaginal pH groups, respectively. Linear regression analysis revealed no significant association between vaginal pH and Bishop’s score change over 12 hours, time to active labor, time to complete dilation, or time to delivery. Discussion: Vaginal pH has significant effect on cervical ripening but has no effect on delivery outcomes in post-term patients with unfavorable cervices, who undergo cervical priming/labor induction using sustained-release dinoprostone vaginal insert.

Anahtar Kelime: Cervical Ripening Vagina Delivery, Obstetric Labor, Induced Hydrogen-Ion Concentration Double-Blind Method Dinoprostone Prospective Studies Delayed-Action Preparations

Konular: Kadın Hastalıkları ve Doğum

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	ÖNEN Ş, Ozaksit G, Yılmaz B, Gungor T, BİLGE Ü, Süt N, Mollamahmutoglu L (2008). The role of vaginal ph on efficacy of controlled-release dinoprostone vaginal ınsert for cervical ripening/labor induction: A prospective double-blind study. , 206 - 211.
Chicago	ÖNEN Şahin,Ozaksit Gulnur,Yılmaz Bülent,Gungor Tayfun,BİLGE Ümit,Süt Necdet,Mollamahmutoglu Leyla The role of vaginal ph on efficacy of controlled-release dinoprostone vaginal ınsert for cervical ripening/labor induction: A prospective double-blind study. (2008): 206 - 211.
MLA	ÖNEN Şahin,Ozaksit Gulnur,Yılmaz Bülent,Gungor Tayfun,BİLGE Ümit,Süt Necdet,Mollamahmutoglu Leyla The role of vaginal ph on efficacy of controlled-release dinoprostone vaginal ınsert for cervical ripening/labor induction: A prospective double-blind study. , 2008, ss.206 - 211.
AMA	ÖNEN Ş,Ozaksit G,Yılmaz B,Gungor T,BİLGE Ü,Süt N,Mollamahmutoglu L The role of vaginal ph on efficacy of controlled-release dinoprostone vaginal ınsert for cervical ripening/labor induction: A prospective double-blind study. . 2008; 206 - 211.
Vancouver	ÖNEN Ş,Ozaksit G,Yılmaz B,Gungor T,BİLGE Ü,Süt N,Mollamahmutoglu L The role of vaginal ph on efficacy of controlled-release dinoprostone vaginal ınsert for cervical ripening/labor induction: A prospective double-blind study. . 2008; 206 - 211.
IEEE	ÖNEN Ş,Ozaksit G,Yılmaz B,Gungor T,BİLGE Ü,Süt N,Mollamahmutoglu L "The role of vaginal ph on efficacy of controlled-release dinoprostone vaginal ınsert for cervical ripening/labor induction: A prospective double-blind study." , ss.206 - 211, 2008.
ISNAD	ÖNEN, Şahin vd. "The role of vaginal ph on efficacy of controlled-release dinoprostone vaginal ınsert for cervical ripening/labor induction: A prospective double-blind study". (2008), 206-211.

APA	ÖNEN Ş, Ozaksit G, Yılmaz B, Gungor T, BİLGE Ü, Süt N, Mollamahmutoglu L (2008). The role of vaginal ph on efficacy of controlled-release dinoprostone vaginal ınsert for cervical ripening/labor induction: A prospective double-blind study. Journal of the Turkish-German Gynecological Association, 9(4), 206 - 211.
Chicago	ÖNEN Şahin,Ozaksit Gulnur,Yılmaz Bülent,Gungor Tayfun,BİLGE Ümit,Süt Necdet,Mollamahmutoglu Leyla The role of vaginal ph on efficacy of controlled-release dinoprostone vaginal ınsert for cervical ripening/labor induction: A prospective double-blind study. Journal of the Turkish-German Gynecological Association 9, no.4 (2008): 206 - 211.
MLA	ÖNEN Şahin,Ozaksit Gulnur,Yılmaz Bülent,Gungor Tayfun,BİLGE Ümit,Süt Necdet,Mollamahmutoglu Leyla The role of vaginal ph on efficacy of controlled-release dinoprostone vaginal ınsert for cervical ripening/labor induction: A prospective double-blind study. Journal of the Turkish-German Gynecological Association, vol.9, no.4, 2008, ss.206 - 211.
AMA	ÖNEN Ş,Ozaksit G,Yılmaz B,Gungor T,BİLGE Ü,Süt N,Mollamahmutoglu L The role of vaginal ph on efficacy of controlled-release dinoprostone vaginal ınsert for cervical ripening/labor induction: A prospective double-blind study. Journal of the Turkish-German Gynecological Association. 2008; 9(4): 206 - 211.
Vancouver	ÖNEN Ş,Ozaksit G,Yılmaz B,Gungor T,BİLGE Ü,Süt N,Mollamahmutoglu L The role of vaginal ph on efficacy of controlled-release dinoprostone vaginal ınsert for cervical ripening/labor induction: A prospective double-blind study. Journal of the Turkish-German Gynecological Association. 2008; 9(4): 206 - 211.
IEEE	ÖNEN Ş,Ozaksit G,Yılmaz B,Gungor T,BİLGE Ü,Süt N,Mollamahmutoglu L "The role of vaginal ph on efficacy of controlled-release dinoprostone vaginal ınsert for cervical ripening/labor induction: A prospective double-blind study." Journal of the Turkish-German Gynecological Association, 9, ss.206 - 211, 2008.
ISNAD	ÖNEN, Şahin vd. "The role of vaginal ph on efficacy of controlled-release dinoprostone vaginal ınsert for cervical ripening/labor induction: A prospective double-blind study". Journal of the Turkish-German Gynecological Association 9/4 (2008), 206-211.