Abstract
Objective
To validate a mathematical model to predict the mean time to delivery (TTD) following
cervical ripening with dinoprostone vaginal insert (DVI), and assess its impact on
the risk of nocturnal deliveries.
Methods
We performed a case-control retro-prospective study at Angers University Hospital.
In the control group, we retrospectively included 405 patients who underwent cervical
ripening with DVI between 01/2015 and 09/2016. Based on the delivery outcomes, we
developed a mathematical model that integrates all the factors influencing TTD following
cervical ripening with DVI. In the study group, we prospectively included 223 patients
who underwent cervical ripening with DVI between 11/2017 and 11/2018. The timing of
insertion was calculated using the mathematical model developed in the control group,
in order to prevent the occurrence of nocturnal deliveries.
Results
The calculated mean TTD was significantly shorter than the real mean TTD (21h46 min ± 3h28 min
versus 25h38 min ± 12h10 min, p < 0.001), and for 44% of patients, there was at least
10 h difference between the two. The real TTD (25h38 min ± 12H10 min versus 20h39 min ± 10h49,
p < 0.001), and the rate of nocturnal deliveries (30.5% versus 21.2%, p = 0.01) were
significantly higher in the study group compared to the control group.
Conclusion
The mathematical model did not help predicting TTD following cervical ripening with
DVI, and or reducing the number of nocturnal deliveries.
Keywords
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Article info
Publication history
Published online: August 31, 2021
Accepted:
August 27,
2021
Received in revised form:
August 24,
2021
Received:
June 15,
2021
Identification
Copyright
© 2021 Elsevier B.V. All rights reserved.
