Abstract

Background: Dinoprostone is a synthetic prostaglandin (PG) that induces labor. In multiparity, the use of dinoprostone could be stressful and dangerous. Thereby, this study aimed to evaluate the safety of vaginal dinoprostone (PROPESS) Prostaglandins E2 (PGE2) used for the induction of labor in grand multiparous women and great grand multipara (GMP).
Methods: This was a retrospective chart review that was conducted on all GMP and great GMP women whose labor was induced by dinoprostone. The study was conducted at King Abdulaziz Medical City, the National Guard Hospital located in Jeddah in the Western region of Saudi Arabia, in the period from 2018 to 2020.
Results: The grand multiparous women were 353 from the total deliveries observed with a mean ± SD age of 36.6 ± 5 years. Results showed that 95.75% labor induction success was achieved by dinoprostone, and 92.1% was delivered via spontaneous vaginal delivery. The major causes of labor induction included gestational diabetes mellitus (45.6%) and post-date (34.3%). The success of dinoprostone was significantly influenced by maternal age (p = 0.006) and gestational age (p = 0.03). No severe maternal complications were observed such as infection or uterine rupture, or cesarean hysterectomy or maternal death.
Conclusion: There were no major complications reported after inducing by dinoprostone. Thus, as no adverse events were reported in this study, it is safe to use vaginal PGE2 Dinoprostone for the induction of labor in grand multiparous women and in great grand multiparous women. However, randomized controlled trial for further validation of these findings is recommended.

Key words: Dinoprostone, safety, labor induction, grand multipara, pregnant women.