Laura Camila Molina-Barrera, María Sady Bustamante-De la Ossa, John Jairo Zuleta-Tobón
{"title":"地诺前列酮引产治疗妊娠期高血压疾病：与血压正常孕妇的比较分析。","authors":"Laura Camila Molina-Barrera, María Sady Bustamante-De la Ossa, John Jairo Zuleta-Tobón","doi":"10.25100/cm.v56i1.6719","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To describe obstetric outcomes associated with the use of dinoprostone and its effectiveness in cervical ripening in pregnant women with hypertensive disorders of pregnancy compared to normotensive pregnant women.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted at a tertiary-level hospital in Medellín, Colombia (March 2020 - October 2024). The study included pregnant women with singleton pregnancies, beyond 30 weeks of gestation, with a live fetus in cephalic presentation, and undergoing cervical ripening with dinoprostone vaginal insert. Women were excluded if they had used other ripening methods, had a favorable cervix at admission, or had an unclassified hypertensive disorder. Primary outcomes included successful cervical ripening, vaginal delivery, time to favorable Bishop score and to delivery, and indications for cesarean section. Adverse events considered were placental abruption, non-reassuring fetal status, tachysystole, and worsening of hypertensive condition.</p><p><strong>Results: </strong>A total of 400 patients were included (200 with hypertensive disorders, of whom 100 had severe preeclampsia). The success rate of cervical ripening was similar between patients with hypertensive disorders and healthy women (crude RR: 0.95, 95% CI: 0.88-1.03; adjusted RR for gestational age, maternal age, and parity 0.96, 95% CI: 0.88-1.04). The vaginal delivery rate was also similar (44% vs. 55%, <i>p</i>= 0.16). The median time to favorable Bishop score and to delivery was comparable between normotensive and hypertensive groups, even in severe cases. Cesarean delivery was mainly due to failed ripening and medical decision. Adverse events, except for tachysystole, were more frequent in the hypertensive group but did not reach statistical significance.</p><p><strong>Conclusion: </strong>Dinoprostone is effective in hypertensive pregnant women, including those receiving magnesium sulfate, with no significant differences compared to normotensive women.</p>","PeriodicalId":50667,"journal":{"name":"Colombia Medica","volume":"56 1","pages":"e2016719"},"PeriodicalIF":0.7000,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12203923/pdf/","citationCount":"0","resultStr":"{\"title\":\"Induction of labor with dinoprostone in hypertensive disorders of pregnancy: comparative analysis with normotensive pregnant women.\",\"authors\":\"Laura Camila Molina-Barrera, María Sady Bustamante-De la Ossa, John Jairo Zuleta-Tobón\",\"doi\":\"10.25100/cm.v56i1.6719\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To describe obstetric outcomes associated with the use of dinoprostone and its effectiveness in cervical ripening in pregnant women with hypertensive disorders of pregnancy compared to normotensive pregnant women.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted at a tertiary-level hospital in Medellín, Colombia (March 2020 - October 2024). The study included pregnant women with singleton pregnancies, beyond 30 weeks of gestation, with a live fetus in cephalic presentation, and undergoing cervical ripening with dinoprostone vaginal insert. Women were excluded if they had used other ripening methods, had a favorable cervix at admission, or had an unclassified hypertensive disorder. Primary outcomes included successful cervical ripening, vaginal delivery, time to favorable Bishop score and to delivery, and indications for cesarean section. Adverse events considered were placental abruption, non-reassuring fetal status, tachysystole, and worsening of hypertensive condition.</p><p><strong>Results: </strong>A total of 400 patients were included (200 with hypertensive disorders, of whom 100 had severe preeclampsia). The success rate of cervical ripening was similar between patients with hypertensive disorders and healthy women (crude RR: 0.95, 95% CI: 0.88-1.03; adjusted RR for gestational age, maternal age, and parity 0.96, 95% CI: 0.88-1.04). The vaginal delivery rate was also similar (44% vs. 55%, <i>p</i>= 0.16). The median time to favorable Bishop score and to delivery was comparable between normotensive and hypertensive groups, even in severe cases. Cesarean delivery was mainly due to failed ripening and medical decision. Adverse events, except for tachysystole, were more frequent in the hypertensive group but did not reach statistical significance.</p><p><strong>Conclusion: </strong>Dinoprostone is effective in hypertensive pregnant women, including those receiving magnesium sulfate, with no significant differences compared to normotensive women.</p>\",\"PeriodicalId\":50667,\"journal\":{\"name\":\"Colombia Medica\",\"volume\":\"56 1\",\"pages\":\"e2016719\"},\"PeriodicalIF\":0.7000,\"publicationDate\":\"2025-03-30\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12203923/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Colombia Medica\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.25100/cm.v56i1.6719\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q3\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Colombia Medica","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.25100/cm.v56i1.6719","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
Induction of labor with dinoprostone in hypertensive disorders of pregnancy: comparative analysis with normotensive pregnant women.
Objective: To describe obstetric outcomes associated with the use of dinoprostone and its effectiveness in cervical ripening in pregnant women with hypertensive disorders of pregnancy compared to normotensive pregnant women.
Methods: A retrospective cohort study was conducted at a tertiary-level hospital in Medellín, Colombia (March 2020 - October 2024). The study included pregnant women with singleton pregnancies, beyond 30 weeks of gestation, with a live fetus in cephalic presentation, and undergoing cervical ripening with dinoprostone vaginal insert. Women were excluded if they had used other ripening methods, had a favorable cervix at admission, or had an unclassified hypertensive disorder. Primary outcomes included successful cervical ripening, vaginal delivery, time to favorable Bishop score and to delivery, and indications for cesarean section. Adverse events considered were placental abruption, non-reassuring fetal status, tachysystole, and worsening of hypertensive condition.
Results: A total of 400 patients were included (200 with hypertensive disorders, of whom 100 had severe preeclampsia). The success rate of cervical ripening was similar between patients with hypertensive disorders and healthy women (crude RR: 0.95, 95% CI: 0.88-1.03; adjusted RR for gestational age, maternal age, and parity 0.96, 95% CI: 0.88-1.04). The vaginal delivery rate was also similar (44% vs. 55%, p= 0.16). The median time to favorable Bishop score and to delivery was comparable between normotensive and hypertensive groups, even in severe cases. Cesarean delivery was mainly due to failed ripening and medical decision. Adverse events, except for tachysystole, were more frequent in the hypertensive group but did not reach statistical significance.
Conclusion: Dinoprostone is effective in hypertensive pregnant women, including those receiving magnesium sulfate, with no significant differences compared to normotensive women.
期刊介绍：
Colombia Médica is an international peer-reviewed medical journal that will consider any original contribution that advances or illuminates medical science or practice, or that educates to the journal''s’ readers.The journal is owned by a non-profit organization, Universidad del Valle, and serves the scientific community strictly following the International Committee of Medical Journal Editors (ICMJE) and the World Association of Medical Editors (WAME) recommendations of policies on publication ethics policies for medical journals.
Colombia Médica publishes original research articles, viewpoints and reviews in all areas of medical science and clinical practice. However, Colombia Médica gives the highest priority to papers on general and internal medicine, public health and primary health care.
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