Journal of Gynecology & Neonatal Biology
Cervical Ripening with an Osmotic Dilator (Dilapan-S) in Term Pregnancies— An Observational Study
- 1Department of gynecology and obstetrics, Vivantes Klinikum im Friedrichshain, Berlin, Germany
- 2Institute for medical statistics, Berlin, Germany
Josefine Maier, Department of gynecology and obstetrics, Vivantes Klinikum im Friedrichshain, Berlin, Germany. E-mail: firstname.lastname@example.org
Maier, J.T., et al. Cervical Ripening with an Osmotic Dilator (Dilapan- S) in Term Pregnancies – An Observational Study. J Gynecol Neonatal Biol 1(2): 1- 6.
© 2015 Maier, J.T. This is an Open access article distributed under the terms of Creative Commons Attribution 4.0 International License.
KeywordsMechanical cervical ripening; Induction of labor; Vaginal birth after cesarean section (VBAC); Prolonged pregnancy; Dilapan-S; Dilasoft; Bishop score; Dinoprostone; Minprostin; Misoprostol; Prepidil; Oxytocin; Maternal age
Objective: The procedure of labor induction becomes increasingly important as the number of pregnancies requiring induction rises in the Western countries due to multiple reasons. In addition, a growing number of patients is aiming to achieve vaginal birth after cesarean section (VBAC). No pharmacological agent is licensed in this group of patients. A newly developed hydrophilic agent (Dilapan-S) is now available for cervical ripening, and is indicated also for patients with a previous cesarean section.
Methods: Observational, non-interventional study in a tertiary perinatal center in Berlin, Germany in 2014. Eighty-three women at term with a singleton pregnancy and cephalic presentation were included.
Results: In total, 60.2% of patients delivered vaginally, 4.8% by ventouse/forceps and 34.9% by secondary cesarean section. Parous women were found to have a significantly higher chance of vaginal birth (82.6% vs. 60.2% in total, p = 0.019). Patient’s ≥ 35 years showed a tendency towards increased rates of ventouse and cesarean section (11.1% vs. 4.8% and 38.9% vs. 34.9% respectively). There was a tendency towards a higher rate of vaginal birth in patients with previous cesarean section (66.7% vs. 59.2%). No adverse fetal or maternal outcomes were noted.
Conclusions: The application of Dilapan-S is cost-effective as patients can be seen in outpatient care. The device is efficient and safe. It is an attractive option for physicians and patients to lower the cesarean section rate by facilitating VBAC.