Factors Affecting Successful Vaginal Birth Following Dinoprostone Administration in Post-term Pregnancies

Objective: This study will determine the success rates of the predictive factors of vaginal birth in the post-term labor induction of the cervical ripening slow-release insert dinoprostone. Material and Methods: All patients who underwent labor induction were post-term pregnant patients. Post-term pregnancy was defined as lasting >= 42+0 weeks of gestation. Dinoprostone insertion into the posterior fornix was performed according to the Bishop score (<= 6) and maintained for a maximum of 24 hours. Parity, Bishop score, maternal age, fetal gender, and induction time were identified as candidate predictors. The traditional logistic regression method was used to examine the relationship between the outcome and candidate predictors. Discrimination in the model was evaluated by calculating the c-index. Results: Of the 25,678 deliveries that occurred during the study period, 361 (1.4%) women underwent post-term delivery; of these, 293 (81%) succeeded, and 68 (19%) failed to achieve cervical ripening using the dinoprostone slow-release vaginal insert. Three predictors were strongly associated with dinoprostone vaginal delivery success: multiparity (2.88[1.38-6.01]), fetal gender (1.69[0.9-3.0]), and Bishop score (OR: 1.59 [1.45-1.70]). Conclusion: The success of vaginal delivery can be predicted by evaluating factors, including fetal gender, parity, and the Bishop score in post-term pregnancies. Including these factors in the management protocol for labor induction with cervical ripening could improve care quality.