Using Dilapan to Help Women with Previous C-Sections Have Vaginal Births
Author Information
Author(s): Dorairajan Gowri, Ravi Saranya, Chinnakili Palanivel
Primary Institution: Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
Hypothesis
The study aims to find the vaginal birth rates, improvement of Bishop score, and safety of osmotic dilator (Dilapan-S) among women with previous caesarean pregnancy.
Conclusion
The hygroscopic dilator Dilapan effectively ripens the cervix before labour induction in women with a previous caesarean scar and is safe, but more extensive studies are needed to evaluate scar-related complications during labour.
Supporting Evidence
- Eighty-two women completed the study.
- The Bishop score significantly improved from a mean of 2.6 before to 5.3 after Dilapan.
- Forty-one (52%) achieved active labour.
- Twenty-seven delivered vaginally, resulting in a 34% vaginal birth rate.
- None had entrapment, fragmentation, or upward displacement of Dilapan.
Takeaway
This study tested a special device to help women who had a C-section give birth vaginally. It worked well and was safe for most women.
Methodology
This was a single-group clinical trial where women with a previous caesarean section were given osmotic dilators to ripen the cervix before inducing labour.
Potential Biases
There was no blinding after assignment to intervention or outcome measurement.
Limitations
The study did not have a control group and relied on a clinically assessed Bishop score, which is subjective.
Participant Demographics
Women over 18 years with a previous lower segment caesarean section and a singleton fetus in vertex presentation.
Statistical Information
P-Value
p<0.001
Confidence Interval
−2.96 to −2.287
Statistical Significance
p<0.001
Digital Object Identifier (DOI)
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