Retracted Dilapan-s in a multiparous woman at term on induction of labour

Abstract

The use of Dilapan-S as an agent of induction of labour has recently gained a lot of attention for its efficiency, safety profile and lack of foetal complications. However, one of its known complications is the retraction of the rods into the uterus. Fortunately, the incidence is very rare, but the mechanisms remain elusive and poorly understood. This paper is about a multiparous woman at 39 weeks with unfavourable cervix and a multiparous os who was admitted for IOL using Dilapan-S. During the digital insertion of the 5th rod, she spontaneously ruptured her membranes with retraction of four of the rods into the uterus. Soon after, she developed uterine contractions and was transferred into the delivery suite with an improved Bishop score and a cervical dilatation of 3 cm. An augmentation of labour was commenced with oxytocin but was later discontinued due to a suspicious CTG trace. She had an emergency caesarean section for maternal request with the delivery of a healthy baby and retrieval of the four Dilapan-S rods intra-operative.