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For: Sarumi MA, Gherman RB, Bell TD, Jairath P, Johnson MJ, Burgess AL. A comparison of cervical ripening modalities among overweight and obese nulliparous gravidas. J Matern Fetal Neonatal Med 2019;33:3804-3808. [PMID: 30810422 DOI: 10.1080/14767058.2019.1586877] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]

For:	Sarumi MA, Gherman RB, Bell TD, Jairath P, Johnson MJ, Burgess AL. A comparison of cervical ripening modalities among overweight and obese nulliparous gravidas. J Matern Fetal Neonatal Med 2019;33:3804-3808. [PMID: 30810422 DOI: 10.1080/14767058.2019.1586877] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]

Number

Cited by Other Article(s)

Pongsatha S, Suntornlimsiri N, Tongsong T. Effectiveness and adverse effects of vaginal misoprostol as a single agent for second trimester pregnancy termination: the impact of fetal viability. Arch Gynecol Obstet 2024;309:1459-1466. [PMID: 37149516 DOI: 10.1007/s00404-023-07068-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 05/01/2023] [Indexed: 05/08/2023]

Ducarme G, Gilman S, Sauvee M, Planche L. Cervical ripening balloon compared with vaginal dinoprostone for cervical ripening in obese women at term: A prospective cohort study. Int J Gynaecol Obstet 2024. [PMID: 38520064 DOI: 10.1002/ijgo.15480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 03/04/2024] [Accepted: 03/09/2024] [Indexed: 03/25/2024]

Abstract

OBJECTIVE

To evaluate vaginal delivery in obese women who underwent cervical ripening at term using a dinoprostone vaginal insert or a cervical ripening balloon (CRB), and to assess maternal and neonatal morbidity according to the method.

METHODS

A prospective cohort study including obese women with a live singleton fetus in cephalic presentation who required cervical ripening at term (≥37 weeks) for maternal and/or fetal disease using a dinoprostone vaginal insert or a CRB. The primary outcome was vaginal delivery. Secondary outcomes were a favorable cervix (Bishop score >6) after 24 h, the time from device insertion to delivery, and composite maternal and neonatal morbidity.

RESULTS

In total, 135 consecutive women were analyzed (107 CRB, 79.3%; 28 dinoprostone vaginal insert, 20.7%). Vaginal delivery (86 [80.4%] after CRB vs 19 [67.9%] after dinoprostone vaginal insert; P = 0.248), favorable cervix within 24 h after device placement (52 [48.6%] vs 17 [60.7%]; P = 0.264), and maternal morbidity (12 [11.2%] vs 4 [14.3%]; P = 0.646) were similar between the groups. The time from device insertion to delivery also did not differ between the groups. Neonatal morbidity was significantly higher after the dinoprostone vaginal insert (11 [39.3%] vs 20 [18.7%]; P = 0.030). Cervical ripening using the dinoprostone vaginal insert, compared with the CRB, was significantly associated with neonatal morbidity (adjusted odds ratio 4.00, 95% confidence interval 1.34-12.5), but not with maternal morbidity (adjusted odds ratio 1.23, 95% confidence interval 0.30-4.38).

CONCLUSIONS

Vaginal delivery, a favorable cervix after 24 h, the time from device insertion to delivery, and maternal morbidity did not significantly differ between the CRB and the dinoprostone vaginal insert for cervical ripening in obese women at term. Nevertheless, neonatal morbidity was significantly associated with the dinoprostone vaginal insert, compared with the CRB, among obese women who required cervical ripening at term.

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Croll DMR, De Vaan MDT, Moes SL, Bloemenkamp KWM, Ten Eikelder MLG, De Heus R, Jozwiak M, Kooiman J, Mol BW, Verhoeven CJM, De Boer MA. Methods of induction of labor in women with obesity: A secondary analysis of two multicenter randomized controlled trials. Acta Obstet Gynecol Scand 2024;103:470-478. [PMID: 38183287 PMCID: PMC10867363 DOI: 10.1111/aogs.14737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 09/28/2023] [Accepted: 10/02/2023] [Indexed: 01/08/2024]

Abstract

INTRODUCTION

Obesity is an increasing public health concern worldwide and can lead to more complications in pregnancy and childbirth. Women with obesity more often require induction of labor for various indications. The aim of this study is to assess which method of induction of labor is safest and most effective in women with obesity.

MATERIAL AND METHODS

This is a secondary analysis of two randomized controlled trials about induction of labor. Women with a term singleton pregnancy in cephalic presentation, an unfavorable cervix, intact membranes and without a previous cesarean section were randomly allocated to cervical priming with a Foley catheter or vaginal prostaglandin-E2-gel (PROBAAT-I) or a Foley catheter or oral misoprostol (PROBAAT-II). The inclusion and exclusion criteria for the studies were identical. Induction methods were compared in women with obesity (body mass index ≥30.0). Main outcomes were cesarean section and postpartum hemorrhage (blood loss >1000 mL).

RESULTS

A total of 2664 women, were included in the trials, 517 of whom were obese: 254 women with obesity received a Foley catheter, 176 oral misoprostol and 87 prostaglandin E2 (PGE2). A cesarean section was performed in 29.1% of women allocated to Foley vs 22.2% in the misoprostol and 23.0% in the PGE2 groups. Comparisons between groups revealed no statistically significant differences: the relative risk [RR] was 1.31 (95% confidence interval [CI] 0.94-1.84) in the Foley vs misoprostol group and 1.27 (95% CI 0.83-1.95) in the Foley vs PGE2 group. The rates of postpartum hemorrhage were comparable (10.6%, 11.4% and 6.9%, respectively; P = 0.512). In women with obesity, more often a switch to another method occurred in the Foley group, (20.1% vs 6.3% in misoprostol vs 1.1% in the PGE2 group; P < 0.001). The risk of a failed Foley placement was higher in women with obesity than in women without obesity (8.3% vs 3.2%; adjusted odds ratio 3.12, 95% CI 1.65-5.90).

CONCLUSIONS

In women with obesity we found a nonsignificant trend towards an increased rate of cesarean sections in the group induced with a Foley catheter compared to oral misoprostol; however, the study lacked power for this subgroup analysis. The finding of a higher risk of failed placement of a Foley catheter in women with obesity can be used in shared decision making.

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Estrade M, Diguisto C, Arnaud C, Ehlinger V, Vayssière PC. Comparison of cesarean delivery rates after 3 methods of cervical ripening among obese women at or after 41 weeks - Secondary analysis of two French randomized controlled trials: MAGPOP and CYTOPRO. Eur J Obstet Gynecol Reprod Biol 2023;291:16-21. [PMID: 37806026 DOI: 10.1016/j.ejogrb.2023.09.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 09/19/2023] [Accepted: 09/22/2023] [Indexed: 10/10/2023]

Lauterbach R, Ben Zvi D, Dabaja H, Zidan R, Justman N, Vitner D, Beloosesky R, Ghanem N, Ginsberg Y, Zipori Y, Weiner Z, Khatib N. Vaginal Dinoprostone Insert versus Cervical Ripening Balloon for Term Induction of Labor in Obese Nulliparas-A Randomized Controlled Trial. J Clin Med 2022;11:jcm11082138. [PMID: 35456231 PMCID: PMC9029246 DOI: 10.3390/jcm11082138] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 04/05/2022] [Accepted: 04/07/2022] [Indexed: 01/27/2023] Open

Affiliation(s)

Roy Lauterbach Department of Obstetrics and Gynecology, Rambam Health Care Campus, Haifa 3109601, Israel; (D.B.Z.); (H.D.); (R.Z.); (N.J.); (D.V.); (R.B.); (N.G.); (Y.G.); (Y.Z.); (Z.W.); (N.K.) Correspondence: ; Tel.: +972-4-7771779; Fax: +972-4-7771778
Dikla Ben Zvi Department of Obstetrics and Gynecology, Rambam Health Care Campus, Haifa 3109601, Israel; (D.B.Z.); (H.D.); (R.Z.); (N.J.); (D.V.); (R.B.); (N.G.); (Y.G.); (Y.Z.); (Z.W.); (N.K.)
Haneen Dabaja Department of Obstetrics and Gynecology, Rambam Health Care Campus, Haifa 3109601, Israel; (D.B.Z.); (H.D.); (R.Z.); (N.J.); (D.V.); (R.B.); (N.G.); (Y.G.); (Y.Z.); (Z.W.); (N.K.)
Ragda Zidan Department of Obstetrics and Gynecology, Rambam Health Care Campus, Haifa 3109601, Israel; (D.B.Z.); (H.D.); (R.Z.); (N.J.); (D.V.); (R.B.); (N.G.); (Y.G.); (Y.Z.); (Z.W.); (N.K.)
Naphtali Justman Department of Obstetrics and Gynecology, Rambam Health Care Campus, Haifa 3109601, Israel; (D.B.Z.); (H.D.); (R.Z.); (N.J.); (D.V.); (R.B.); (N.G.); (Y.G.); (Y.Z.); (Z.W.); (N.K.)
Dana Vitner Department of Obstetrics and Gynecology, Rambam Health Care Campus, Haifa 3109601, Israel; (D.B.Z.); (H.D.); (R.Z.); (N.J.); (D.V.); (R.B.); (N.G.); (Y.G.); (Y.Z.); (Z.W.); (N.K.)
Ron Beloosesky Department of Obstetrics and Gynecology, Rambam Health Care Campus, Haifa 3109601, Israel; (D.B.Z.); (H.D.); (R.Z.); (N.J.); (D.V.); (R.B.); (N.G.); (Y.G.); (Y.Z.); (Z.W.); (N.K.) Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa 3200003, Israel
Nadir Ghanem Department of Obstetrics and Gynecology, Rambam Health Care Campus, Haifa 3109601, Israel; (D.B.Z.); (H.D.); (R.Z.); (N.J.); (D.V.); (R.B.); (N.G.); (Y.G.); (Y.Z.); (Z.W.); (N.K.)
Yuval Ginsberg Department of Obstetrics and Gynecology, Rambam Health Care Campus, Haifa 3109601, Israel; (D.B.Z.); (H.D.); (R.Z.); (N.J.); (D.V.); (R.B.); (N.G.); (Y.G.); (Y.Z.); (Z.W.); (N.K.) Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa 3200003, Israel
Yaniv Zipori Department of Obstetrics and Gynecology, Rambam Health Care Campus, Haifa 3109601, Israel; (D.B.Z.); (H.D.); (R.Z.); (N.J.); (D.V.); (R.B.); (N.G.); (Y.G.); (Y.Z.); (Z.W.); (N.K.)
Zeev Weiner Department of Obstetrics and Gynecology, Rambam Health Care Campus, Haifa 3109601, Israel; (D.B.Z.); (H.D.); (R.Z.); (N.J.); (D.V.); (R.B.); (N.G.); (Y.G.); (Y.Z.); (Z.W.); (N.K.) Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa 3200003, Israel
Nizar Khatib Department of Obstetrics and Gynecology, Rambam Health Care Campus, Haifa 3109601, Israel; (D.B.Z.); (H.D.); (R.Z.); (N.J.); (D.V.); (R.B.); (N.G.); (Y.G.); (Y.Z.); (Z.W.); (N.K.) Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa 3200003, Israel

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Ashraf R, Maxwell C, D'Souza R. Induction of labour in pregnant individuals with obesity. Best Pract Res Clin Obstet Gynaecol 2021;79:70-80. [PMID: 35031244 DOI: 10.1016/j.bpobgyn.2021.12.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 12/15/2021] [Accepted: 12/16/2021] [Indexed: 12/14/2022]