{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T04:47:03Z","timestamp":1777870023775,"version":"3.51.4"},"reference-count":29,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T00:00:00Z","timestamp":1765152000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T00:00:00Z","timestamp":1765152000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Induction of labor is a prevalent obstetric procedure designed to artificially initiate the labor process, which is critical for achieving vaginal delivery. A key factor influencing the success of induction of labor is cervical ripening, assessed using the Bishop score. A low Bishop score (0\u20133) indicates an unfavorable cervix and is associated with a higher risk of induction failure. This study aims to compare the efficacy of two approaches to labor induction: the sequential use of mifepristone followed by dinoprostone (two\u2010step approach) versus dinoprostone alone (one\u2010step approach) in women with a very low Bishop score.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A secondary analysis was conducted on data from a multicenter clinical trial involving 503 women with non\u2010urgent indications for induction of labor. Of these, 296 participants met the inclusion criteria and were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The results demonstrated that pretreatment with mifepristone significantly improved labor outcomes. The vaginal delivery rate was 73.4% in the mifepristone group compared to 51.5% in the dinoprostone\u2010only group (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). Additionally, the interval from dinoprostone insertion to delivery was shorter in the mifepristone group, and the rate of failed induction was significantly lower (1.0% vs. 6.5%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>These findings suggest that the sequential use of mifepristone prior to dinoprostone administration enhances the likelihood of successful labor induction in women with a very low Bishop score. The study highlights the importance of optimizing cervical ripening methods to improve labor outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ijgo.70726","type":"journal-article","created":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T11:05:21Z","timestamp":1765191921000},"page":"1114-1121","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of the sequential use of mifepristone and dinoprostone vaginal insert with dinoprostone vaginal insert as the only method for induction of labor in very unripe cervix: a secondary analysis of a multicenter real\u2010word evidence study"],"prefix":"10.1002","volume":"173","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8572-1971","authenticated-orcid":false,"given":"Oleg R.","family":"Baev","sequence":"first","affiliation":[{"name":"National Medical Research Center for Obstetrics, Gynecology and Perinatology Named After Academician V.I. Kulakov of Ministry of Healthcare of the Russian Federation  Moscow Russia"},{"name":"Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Healthcare of the Russian Federation (Sechenov University)  Moscow Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3264-2038","authenticated-orcid":false,"given":"Dmitry A.","family":"Babich","sequence":"additional","affiliation":[{"name":"National Medical Research Center for Obstetrics, Gynecology and Perinatology Named After Academician V.I. Kulakov of Ministry of Healthcare of the Russian Federation  Moscow Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2228-3884","authenticated-orcid":false,"given":"Vitaly B.","family":"Tskhay","sequence":"additional","affiliation":[{"name":"V.F. Voino\u2010Yasenetsky Krasnoyarsk State Medical University, Ministry of Health of Russia  Krasnoyarsk Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7807-4929","authenticated-orcid":false,"given":"Vitaly F.","family":"Bezhenar","sequence":"additional","affiliation":[{"name":"Pavlov First State Medical University, Ministry of Health of Russia  St. Petersburg Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4194-8730","authenticated-orcid":false,"given":"Irina V.","family":"Edilberg","sequence":"additional","affiliation":[{"name":"National Medical Research Center for Obstetrics, Gynecology and Perinatology Named After Academician V.I. Kulakov of Ministry of Healthcare of the Russian Federation  Moscow Russia"},{"name":"Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Healthcare of the Russian Federation (Sechenov University)  Moscow Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7712-1260","authenticated-orcid":false,"given":"Gennady T.","family":"Sukhikh","sequence":"additional","affiliation":[{"name":"National Medical Research Center for Obstetrics, Gynecology and Perinatology Named After Academician V.I. Kulakov of Ministry of Healthcare of the Russian Federation  Moscow Russia"},{"name":"Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Healthcare of the Russian Federation (Sechenov University)  Moscow Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,12,8]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3181b48ef5"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3182114ad2"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000157436.68847.3b"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.12566"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajogmf.2021.100534"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000041068"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.14028"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0029-7844(97)00259-7"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-024-06600-1"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajogmf.2022.100628"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tjog.2024.10.019"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/jog.16123"},{"issue":"10","key":"e_1_2_13_14_1","article-title":"A retrospective comparative study of the effect of controlled\u2010release dinoprostone vaginal delivery system (Propess\u00ae) and mechanical methods for cervical ripening in nulliparous women in late\u2010term pregnancy","volume":"15","author":"Shibata Y","year":"2023","journal-title":"Cureus"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.15552"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2024.12.035"},{"issue":"10","key":"e_1_2_13_17_1","article-title":"Role of mifepristone in induction of labor in full\u2010term pregnancy","volume":"16","author":"Boipai P","year":"2024","journal-title":"Cureus"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2020.03.020"},{"issue":"7","key":"e_1_2_13_19_1","article-title":"Safety and efficacy of oral mifepristone for cervical ripening and induction of labor","volume":"16","author":"Pharande P","year":"2024","journal-title":"Cureus"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1080\/14767058.2019.1671340"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.18565\/aig.2025.80"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.4103\/jpbs.jpbs_1599_24"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/jog.14010"},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2018.07.025"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.humrep.a138124"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.1210\/jcem-65-3-527"},{"key":"e_1_2_13_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1988.tb06840.x"},{"key":"e_1_2_13_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.15952"},{"key":"e_1_2_13_29_1","doi-asserted-by":"publisher","DOI":"10.3109\/14767058.2015.1086331"},{"issue":"100198","key":"e_1_2_13_30_1","article-title":"Comparison of outpatient with inpatient mifepristone usage for cervical ripening: a randomised controlled trial","volume":"18","author":"Baev O","year":"2023","journal-title":"Eur J Obstet Gynecol Reprod Biol"}],"container-title":["International Journal of Gynecology &amp; 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