Labor induction in term premature rupture of membranes: comparison between oxytocin and dinoprostone followed 6 hours later by oxytocin

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The aim of this randomized study was to compare 2 protocols for inducing labor in women with premature rupture of membranes (PROM) at term.

Study Design

Women with PROM and a Bishop score ≤5 were randomly assigned to receive either an intravenous oxytocin infusion (n = 223) or a dinoprostone pessary followed 6 hours later by an intravenous oxytocin infusion (n = 227).


Vaginal delivery within 24 hours of labor induction increased significantly with sustained-released dinoprostone followed by oxytocin infusion (78.5% vs 63.3%; relative risk, 1.23; 95% confidence interval, 1.09–1.39; P = .001). Maternal and neonatal outcomes were similar between the groups.


Sustained-released dinoprostone followed 6 hours later by an oxytocin infusion in term women with PROM was associated with a higher rate of vaginal delivery within 24 hours, and no difference in maternal-neonatal complications was observed compared with oxytocin infusion alone.

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