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J Clin Med 2022 Jun 19;11(12). Epub 2022 Jun 19.

Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Foundation, Tzu Chi University, Hualien 970, Taiwan.

This retrospective study aimed to compare the safety and efficacy of Prostin E2 and Propess for the induction of labor (IOL) in nulliparous women between January 2018 and October 2021. The inclusion criteria were nulliparous, singleton, >37 weeks' gestation, cephalic presentation with an unfavorable cervix (Bishop score ≤ 6), no signs of labor, and use of one form of dinoprostone (Prostin E2 or Propess) for IOL. The cesarean section (C/S) rate and induction-to-birth interval were the main outcome measures. Read More

Int J Gynaecol Obstet 2022 Jun 20. Epub 2022 Jun 20.

Department of Obstetrics and Gynecology, Faculty of Medicine, Universiti Malaya, Jalan Profesor Diraja Ungku Aziz, Kuala Lumpur, Malaysia.

Objective: To evaluate immediate oxytocin and early amniotomy compared to delayed amniotomy after Foley catheter cervical ripening in nulliparous women on intervention to delivery interval.

Methods: A randomized trial was conducted from September 2020-March 2021. 140 term nulliparas (70 early amniotomy, 70 delayed amniotomy) with Foley catheter ripened cervices (dilatation ≥3cm achieved), singleton fetus, cephalic presentation with intact membranes and reassuring fetal heart rate tracing were recruited. Read More

Eur J Midwifery 2022 30;6:33. Epub 2022 May 30.

Sydney Institute for Women, Children and their Families, Sydney Local Health District, Sydney, Australia.

Introduction: Induction of labor (IOL) is rising globally and is growing steadily in the state of New South Wales, Australia. There are numerous methods of induction of labor, including the double balloon catheter (DBC). There is minimal evidence on women's attitudes and experiences and clinician's opinions on the use of the DBC. Read More

J Steroid Biochem Mol Biol 2022 Jun 8;223:106137. Epub 2022 Jun 8.

Division of Basic Research, Department of Obstetrics and Gynecology, The University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; Cecil H. and Ida Green Center for Reproductive Biology Sciences, The University of Texas Southwestern Medical Center, Dallas, TX 75390, USA. Electronic address:

The remodeling of the cervix from a closed rigid structure to one that can open sufficiently for passage of a term infant is achieved by a complex series of molecular events that in large part are regulated by the steroid hormones progesterone and estrogen. Among hormonal influences, progesterone exerts a dominant role for most of pregnancy to initiate a loss of tissue strength yet maintain competence in a phase termed softening. Equally important are the molecular events that abrogate progesterone function in late pregnancy to allow a loss of tissue competence and strength during cervical ripening and dilation. Read More

Obstet Gynecol 2022 Jun 2;139(6):1083-1091. Epub 2022 May 2.

Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, New York; the Department of Obstetrics and Gynecology, University of Texas Medical Branch at Galveston, Galveston, Texas; and NEOX s.r.o., Prague, Czech Republic.

Objective: To evaluate whether a synthetic osmotic cervical dilator is noninferior to oral misoprostol for cervical ripening.

Methods: In an open-label, noninferiority randomized trial, pregnant women undergoing induction of labor at 37 weeks of gestation or more with Bishop scores less than 6 were randomized to either mechanical cervical dilation or oral misoprostol. Participants in the mechanical dilation group underwent insertion of synthetic osmotic cervical dilator rods, and those in the misoprostol group received up to six doses of 25 micrograms orally every 2 hours. Read More

Comput Math Methods Med 2022 27;2022:2617075. Epub 2022 May 27.

Department of Obstetrics, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, 317000 Zhejiang, China.

Objective: The purpose of this study was to investigate the efficacy and safety of phloroglucinol in combination with oxytocin in the induction of labor in women who had experienced term premature rupture of membranes (PROM).

Methods: Data from 100 women who experienced PROM between December 2020 and December 2021 were retrospectively evaluated in this study. The puerperae were categorized into observation and control groups based on their uterine contraction regimens. Read More

J Obstet Gynaecol 2022 Jun 2:1-5. Epub 2022 Jun 2.

Clinic of Obstetrics and Gynecology, University of Health Sciences, Etlik Zübeyde Hanım Women's Health Training and Research Hospital, Ankara, Turkey.

This study was conducted to examine the levels of vitamin D in postterm pregnancy. The study consisted of two groups: Group 1: women with postterm pregnancy in whom labour has not started ( = 40). Group 2: pregnant women with spontaneous labour between 37 and 41 weeks of gestation ( = 40). Read More

J Obstet Gynaecol 2022 Jun 2:1-10. Epub 2022 Jun 2.

Social Determinants of Health Research Center, Faculty of Nursing and Midwifery, Tabriz University of Medical sciences, Tabriz, Iran.

This study assessed the effect of dexamethasone on labour induction, Bishop Score, mean intervals from induction of labour to the active phase and delivery, duration of first and second stages of labour and caesarean section frequency. A search was carried out in PubMed, Cochrane Library, Embase, Ovid, Scopus, ClinicalTrials.gov, Google Scholar and Persian databases. Read More

J Dev Biol 2022 May 20;10(2). Epub 2022 May 20.

Center for Experimental Animals, Tokyo Medical and Dental University, Tokyo 113-8510, Japan.

In humans, the incidence of post-term delivery is 1-10%. Post-term delivery significantly increases the risk of cesarean section or neonatal intensive care unit (NICU) admission. Despite these serious challenges, the cause of prolonged delivery remains unclear. Read More

Gels 2022 Apr 26;8(5). Epub 2022 Apr 26.

Neonatal Unit, Astrid Lindgren's Children's Hospital, Eugeniavägen 23, 171 64 Solna, Sweden.

The aim of this trial was to evaluate the effect of progesterone gel compared to placebo in prolonging pregnancy among women with preterm labor. A randomized controlled trial in Sweden in 2009-18. Women with early preterm labor were randomized to daily doses of progesterone gel 90 mg (n = 28) or placebo (n = 30) after standard intravenous tocolytics. Read More

J Obstet Gynaecol 2022 May 25:1-9. Epub 2022 May 25.

Department of Obstetrics and Gynecology, Al-Azhar University, Faculty of Medicine for Girls, Cairo, Egypt.

We aimed to conduct a systematic review and meta-analysis to compare the efficacy and safety of titrated oral misoprostol versus static oral misoprostol for labour induction. We searched for the available randomised clinical trials (RCTs) in the Cochrane Library, PubMed, ISI web of science, Scopus, and ClinicalTrials.gov. Read More

J Fam Pract 2022 03;71(2):E18-E19

Librarian Emeritus, University of Washington, Seattle.

Evidence-Based Answer: Yes. Compared to the use of a transcervical balloon alone, combined cervical ripening with a balloon catheter and oxytocin shortens the time to overall delivery by 3 hours and the time to vaginal delivery by 4 hours, without altering the rate of cesarean section (strength of recommendation [SOR]: A, network meta-analysis). The effect is more pronounced in nulliparous patients (SOR: A, meta-analysis). Read More

Int J Gynaecol Obstet 2022 07 6;158(1):234. Epub 2022 May 6.

Reproductive Health Research Center, Department of Obstetrics & Gynecology, Al-zahra Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.

Eur J Obstet Gynecol Reprod Biol X 2022 Aug 16;15:100148. Epub 2022 Apr 16.

Rotunda Hospital, Dublin, Ireland.

Objective: There exists uncertainty surrounding the most effective and efficient means of inducing labour, particularly in the setting of an unfavourable cervix. This study aims to determine the merit of repeating dinoprostone administration when a single application has failed to render the cervix favourable for amniotomy.

Study Design: Retrospective analysis of a consecutive cohort of nulliparous women who underwent term induction of labour in a tertiary referral centre in Ireland was conducted over a 12- month period (December 2019 to January 2021). Read More

Arch Gynecol Obstet 2022 Apr 27. Epub 2022 Apr 27.

Service de Gynécologie Obstétrique, Assistance Publique-Hôpitaux de Paris, Hôpital Robert Debré, Paris, France.

Purpose: To assess severe neonatal morbidity and mortality in induced labor in preterm breech deliveries, compared to spontaneous labor.

Methods: This is a retrospective study conducted in a tertiary university center in France. Women with single live breech pregnancy between 28 + 0 and 36 + 6 weeks gestation were included. Read More

J Obstet Gynaecol 2022 Apr 25:1-5. Epub 2022 Apr 25.

Department of Obstetrics & Gynaecology, Mahatma Gandhi Medical College & Research Institute, Sri Balaji Vidyapeeth (Deemed-to-be-University), Pillaiyarkuppam, India.

This study aimed to compare the effect of misoprostol using vaginal or sublingual routes on the non-pregnant uterine cervix prior to minor gynaecological procedures. One hundred and forty women were randomised 1:1 into two groups: A and B. Group A received misoprostol 400 mcg vaginally and pyridoxine 40 mg sublingually and Group B received misoprostol 400 mcg sublingually and pyridoxine 40 mg vaginally 4 h prior to procedure. Read More

J Clin Med 2022 Apr 15;11(8). Epub 2022 Apr 15.

Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Nursing, University of Castilla-La Mancha IDINE, Av. de España, s/n, 02001 Albacete, Spain.

Purpose: To evaluate the effect and safety of vaginal dinoprostone in pregnant women with PROM who undergo induction of labor (IoL).

Materials And Methods: Prospective observational study conducted at La Mancha Centro hospital from 1 February 2019, to 30 August 2020. Obstetric and neonatal variables of 94 pregnant women with PROM who underwent IoL with vaginal dinoprostone were analyzed, and the results were compared with 330 patients without PROM who also underwent IoL. Read More

J Clin Med 2022 Apr 11;11(8). Epub 2022 Apr 11.

Department of Obstetrics and Gynecology, Rambam Health Care Campus, Haifa 3109601, Israel.

Data regarding the preferred induction method in women with obesity is scarce. The current study was aimed at comparing pharmacological and mechanical induction in this population. This prospective randomized controlled trial was conducted between 2016-2020, in nulliparas with a pre-pregnancy body mass index >30. Read More

PLoS One 2022 22;17(4):e0267400. Epub 2022 Apr 22.

Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.

A variety of oxytocin regimens are used for labor induction and augmentation. Considering the increasing rates of labor induction, it is important to assess the most optimal oxytocin regimen without compromising maternal and fetal safety. The aim of this study was to compare delivery outcomes of low-dose and high-dose oxytocin induction protocols. Read More

Reprod Sci 2022 Apr 19. Epub 2022 Apr 19.

Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia.

The objective of this study was to conduct a systematic review and meta-analysis of all randomized controlled trials (RCTs) that evaluated isosorbide mononitrate (ISMN) versus dinoprostone, a prostaglandin E2 (PGE2) analogue, in promoting cervical ripening during labor induction. We searched five major databases from inception till 02 May 2021. We assessed the risk of bias of included studies. Read More

Curr Drug Res Rev 2022 Apr 18. Epub 2022 Apr 18.

Hamadan University of Medical Sciences, Hamadan.

Background: Cervix preparation is one of the main steps in the onset of labor and is very important for success in initiating or inducing labor.

Objective: The present study aimed at investigating the effect of evening primrose vaginal capsule on the preparation of cervix and the consequences of labor in nulliparous women.

Methods: This randomized clinical trial study was conducted in 2018 on 100 nulliparous women referred to Fatemieh Hospital in Hamadan. Read More

J Perinat Med 2022 Apr 18. Epub 2022 Apr 18.

Faculty of Medicine, University of Queensland, Brisbane, Australia.

Objectives: To evaluate the rate of subsequent spontaneous preterm birth in patients with previous induction of labour at term compared to women with previous spontaneous labour at term.

Methods: This was a retrospective cohort study of all women with consecutive births at the Royal Brisbane and Women's Hospital between 2014 and 2018. All nulliparous women with a singleton pregnancy and induction of labour at term or in spontaneous labour at term in the index pregnancy were included. Read More

BMC Pregnancy Childbirth 2022 Apr 13;22(1):316. Epub 2022 Apr 13.

Flinders University, Adelaide, SA, Australia.

Background: Induction of labour (IOL) is a common obstetric intervention. When planning IOL, especially in women at risk for complications at delivery, the aim should be for delivery to occur when senior staff are available to optimise safe care.

Methods: A change in timing of IOL protocol at our institution was introduced in November 2018 aiming to increase births occurring "in-hours" defined as 08:00 to 20:00 h. Read More

Am J Obstet Gynecol MFM 2022 07 28;4(4):100628. Epub 2022 Mar 28.

National Perinatal Epidemiology Unit Clinical Trials Unit, University of Oxford, Oxford, United Kingdom (Ms Hardy).

Background: Induction of labor is a commonly performed obstetrical intervention. Vaginal prostaglandin E2 (dinoprostone) is a first-choice agent. Mechanical methods of induction are slower in achieving cervical ripening but have a lower risk of adverse effects. Read More

Case Rep Womens Health 2022 Apr 23;34:e00406. Epub 2022 Mar 23.

PA Program, University of Texas Medical Branch at Galveston School of Medicine, Galveston, TX, USA.

A 16-year-old primigravida was diagnosed with COVID-19 in her second trimester. She decompensated quickly and had to be admitted to hospital and intubated. She was diagnosed with a fetal demise after being intubated and neurology suspected myasthenia gravis due to neurologic symptoms. Read More

J Clin Med 2022 Mar 10;11(6). Epub 2022 Mar 10.

Department of Obstetrics and Gynecology, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France.

Background: The aim of this study is to demonstrate that a double balloon catheter combined with oxytocin decreases time between induction of labor and delivery (TID) as compared to a vaginal dinoprostone insert in cases of premature rupture of membranes at term.

Methods: This is a prospective, randomized, controlled trial including patient undergoing labor induction for PROM at term with an unfavorable cervix in Clermont-Ferrand university hospital. We compared the double balloon catheter over a period of 12 h with adjunction of oxytocin 6 h after catheter insertion versus dinoprostone vaginal insert. Read More

Clin Appl Thromb Hemost 2022 Jan-Dec;28:10760296221088576

CONACyT-Facultad de Odontologia, Universidad Autonoma Benito Juarez de Oaxaca, Oaxaca de Juarez, Mexico.

The antiphospholipid syndrome (APS), a systemic autoimmune disease characterized by a hypercoagulability associated to vascular thrombosis and/or obstetric morbidity, is caused by the presence of antiphospholipid antibodies such as lupus anticoagulant, anti-β-2-glycoprotein 1, and/or anticardiolipin antibodies. In the obstetrical APS, antiphospholipid antibodies induce the production of proinflammatory cytokines and tissue factor by placental tissues and recruited neutrophils. Moreover, antiphospholipid antibodies activate the complement system which, in turn, induces a positive feedback leading to recruitment of neutrophils as well as activation of the placenta. Read More

Eurasian J Med 2022 02;54(1):72-76

Department of Gynaecology and Obstetrica, Kanuni Sultan Süleyman Training and Research Hospital, Diyarbakır, Turkey.

Objective: The study aimed to evaluate the factors affecting successful vaginal delivery in induction with slow-release dinoprostone at term pregnancy with premature rupture of membranes.

Materials And Methods: Pregnancies between 370/7 and 416/7 gestation weeks with premature rupture of membranes in which slow-release dinoprostone was used for cervical ripening were sought for inclusion in the study. Pregnancies with previous uterine surgery, multiple fetal gestations, chorioamnionitis, non-cephalic presentation, fetal distress at the time of admission, HIV positivity, and estimated fetal weight >4500 on ultrasonographic evaluation were excluded. Read More

Arch Gynecol Obstet 2022 Mar 15. Epub 2022 Mar 15.

Department of Obstetrics and Gynecology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, China.

Purpose: To evaluate the efficacy of intrauterine inflated Cook Cervical Ripening Balloon (ICRB) in postpartum hemorrhage (PPH) management and fertility preserving for placenta accreta spectrum disorders with placenta previa (previa PAS).

Methods: At a tertiary referral center, 74 patients suffering with previa PAS were entered into this retrospective cohort study from January, 2016 to December, 2020, and were confirmed intraoperatively that abnormal invasive placenta reaches the cervical internal ostium and the upper part of the cervical canal. In control group (n = 39), the combination of infrarenal abdominal aorta balloon occlusion (IAABO) and longitudinal parallel compression suture to lower uterine segment were performed. Read More

JCI Insight 2022 03 8;7(5). Epub 2022 Mar 8.

Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, US Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, Maryland, and Detroit, Michigan, USA.

Parturition is a well-orchestrated process characterized by increased uterine contractility, cervical ripening, and activation of the chorioamniotic membranes; yet, the transition from a quiescent to a contractile myometrium heralds the onset of labor. However, the cellular underpinnings of human parturition in the uterine tissues are still poorly understood. Herein, we performed a comprehensive study of the human myometrium during spontaneous term labor using single-cell RNA sequencing (scRNA-Seq). Read More