Study of uterine and fetal hemodynamics in response to labor induction with dinoprostone in prolonged pregnancies with normal amniotic fluid and oligohydramnios

Abstract

Objective: We investigated the effects of labor induction with Dinoprostone on uteroplacental and fetal circulations with Doppler velocimetry in prolonged pregnancies with and without oligohydramnios.Methods: We performed Doppler evaluations of Uterine A, Umbilical A and Middle Cerebral A. (MCA) in 117 patients (27 associated with oligohydramnios) just before and 6 h after the administration of Dinoprostone. We compared two groups with Mann Whitney U Test and Independent Sample T Test.Results: Uterine Artery Doppler indices of both groups obtained before the medication were compared. All indices were within normal range; however Umbilical A. S/D and PI were higher in oligohydramnios group, approaching statistical significance (p = 0.07 for S/D and p = 0.03 for PI). All of the Uterine A. Doppler indices significantly increased after the administration of Dinoprostone ovule in normal amniotic fluid index (AFI) group (p = 0.00). Doppler indices of the other arteries in this group did not change significantly. Similarly, none of the Doppler indices of all investigated arteries in oligohydramnios group changed significantly. Changes in all measured Doppler indices were minor and similar in both groups.Conclusions: Labor induction with Dinoprostone in prolonged pregnancies complicated with oligohydramnios is as safe and effective as it is in prolonged pregnancies with normal AFI.