Relation between dehydroepiandrosterone sulfate (DHEA-S) and success of labour induction in prolonged gestation

Abstract

To evaluate the relationship between maternal Dehydroepiandrosterone sulphate (DHEA-S) and success of labour induction in prolonged gestation. Fifty (50) women with a prolonged pregnancy > 41 weeks were included in the prospective study. After full history, examination, Bishop's score was recorded by two observers, followed by ultrasound scan and cardiotocography (CTG) to assess foetal condition. Ten (10) mL of venous blood was taken for measuring plasma DHEA-S level before induction of labour. Induction of labour was carried out by Misoprostol 25 μg vaginal suppository every 4 hours for 6 doses maximally. Patients in the first, second and third stages of labour were managed according to Ain Shams University Maternity Hospital protocol. The outcome measures, success of labour induction, relation between both DHEA-S and Bishop's score and the success of labour induction. In this study, there was no significant difference between the group of failed induction and group of successful induction regarding the mean age, mean body mass index (BMI), mean parity, mean birth weight, and mean Apgar score at 5 minutes. The mean serum DHEA-S was significantly higher in successful induction group compared to failed induction group (108.2±10.3 versus 44.7±18.3 µg/dL) and the mean Bishop's score was also significantly higher in successful induction group compared to failed induction group (7.3±1.0 versus 4.5±0.5), ( P <0.001). In this study, there was significant direct correlation between serum DHEA-S and Bishop's score, the higher DHEA-S is related to higher Bishop's score ( r =0.785; P <0.001). Using ROC curve, the serum DHEA-S at cutoff level 90.6 μg/dL was a predictor of successful labour induction with 97.2% sensitivity and 92.3% specificity. Pre-induction serum DHEA-S assay can be used beside clinical assessment and Bishop's score to anticipate successful induction of labour in prolonged gestation.