The Iranian Journal of Obstetrics, Gynecology and Infertility

The Iranian Journal of Obstetrics, Gynecology and Infertility

The efficacy of Extra-amniotic dexamethasone infusion in cervical ripening for labor induction: A randomized clinical trial

Document Type : Original Article

Authors
Zahra Mahvi Khomami 1
Shahrzad Aghaamoo 1
Elham Saffarieh 1
Majid Mirmohammadkhani 2
1 Assistant Professor, Department of Obstetrics and Gynecology, Abnormal Uterine Bleeding Research Center, Faculty of Medicine, Semnan University of Medical Sciences, Semnan, Iran.
2 Assistant Professor, Department of Biostatistics, Social Determinants of Health Research Center, Faculty of Medicine, Semnan University of Medical Sciences, Semnan, Iran.
10.22038/ijogi.2023.21819
Abstract
Introduction: There are mechanical and pharmacologic methods of cervical ripening that combination of these methods had better results. This study was performed aimed to investigate the effect of extra-amniotic dexamethasone infusion on cervical ripening and Bishop score, labor duration and maternal and neonatal complications.
Methods: This randomized clinical trial study was performed on 60 term pregnant women with unripe cervix who were candidates for induction of labor in Amiralmomenin hospital of Semnan in 2019-2020. The subjects were randomly assigned into intervention (extra-amniotic dexamethasone infusion through the intracervical catheter) and control groups (extra-amniotic normal saline infusion). Both groups underwent labor induction and the information about the delivery process including latent and active phase duration, time needed for catheter removal, bishop score after catheter removal, cesarean rate and first and fifth minutes Apgar score of neonates entered in a checklist. Data were analyzed by SPSS (version 23) and T-test, U-Man-Whitney and Chi-square tests. P<0.05 was considered statistically significant.
Results:  After the intervention, there was significant difference between the two groups in terms of initial Bishop score and the Bishop score after catheter removal (P=0.028), but duration of catheter removal (P=0.45), mean time of induction onset to delivery (P=0.14), duration of active phase (P=0.84) and latent phase (P=0.83), first and fifth minutes Apgar score (P=0.19) and cesarean rate (P=0.76) were not significantly different between the two groups. 
Conclusion: Extra-amniotic Dexamethasone infusion improves the Bishop score more than the control group, and facilitates cervical ripening for induction of labor.
Keywords
Bishop score
Dexamethasone
Induction of labor
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The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 25, Issue 12
February 2023
Pages 33-42