Effect of vaginal pH in cervical ripening with dinoprostone gel
Jayshree Goswami, Saswati Sanyal Choudhury, Gitanjali Deka
Objective: The purpose of this study was to evaluate whether vaginal pH has an effect on the efficacy of the Dinoprostone gel for cervical ripening. Methodology: Hundred ten women who had indication for labor induction with Bishop's score ≤5 were enrolled in this prospective observational study. After initial vaginal pH and Bishop Score assessment all women received dinoprostone gel intracervically for cervical ripening with repeated dosing twelve hours later or oxytocin / misoprost induction were initiated depending on cervical status. Clinical outcomes were evaluated. Statistical analysis was done using SPSS 16.0. Results: Average initial vaginal pH was 5.305 ± 0.931 (range 3.5-7.5). No significant differences were noted between those patients with vaginal pH≤4.5 (group 1) compared with those with high pH> 4.5 (group II) with respect to maternal age, gestational age and gravidity. Difference in mean initial Bishop Score was slightly significant being 0.0493. Bishop score change over 12 hours (2.57 vs 5.71), time to active labor (21.45 vs. 11.99 hours), induction delivery interval (28.48 vs. 16.67 hours), and mode of delivery (vaginal vs. CS) were highly significant between the two groups. Conclusion: Vaginal pH has significant effect on cervical ripening and delivery outcome.