{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T08:34:02Z","timestamp":1740126842291,"version":"3.37.3"},"reference-count":32,"publisher":"Georg Thieme Verlag KG","issue":"08","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:p>\n            Objective\u2003Saline vaginal douching prior to intravaginal prostaglandin application might increase the vaginal pH, leading to improvement of prostaglandin bioavailability, by which the outcomes of labor induction can be greatly improved. Thus, we aimed to evaluate the effect of vaginal washing with normal saline before insertion of vaginal prostaglandin for labor induction.<\/jats:p><jats:p>\n            Study Design\u2003A systematic search was done in PubMed, Cochrane Library, Scopus, and ISI Web of Science from inception to March 2022. We selected randomized controlled trials (RCTs) that compared vaginal washing using normal saline versus no vaginal washing in the control group before intravaginal prostaglandin insertion during labor induction. We used RevMan software for our meta-analysis. Our main outcomes were the duration of intravaginal prostaglandin application, duration from intravaginal prostaglandin insertion to active phase of labor, duration from intravaginal prostaglandin insertion till total cervical dilatation, labor induction failure rate, incidence of cesarean section (CS), and rates of neonatal intensive care unit (NICU) admission and fetal infection postdelivery.<\/jats:p><jats:p>\n            Results\u2003Five RCTs were retrieved with a total number of 842 patients. Duration of prostaglandin application, duration from prostaglandin insertion to active phase of labor, and time interval from prostaglandin insertion to total cervical dilatation were significantly shorter among vaginal washing group (p\u2009&lt;\u20090.05). Vaginal douching prior to prostaglandin insertion significantly decreased the incidence of failed labor induction (p\u2009&lt;\u20090.001). After the removal of reported heterogeneity, vaginal washing was linked to a significant decline in CS incidence (p\u2009=\u20090.04). In addition, the rates of NICU admission and fetal infection were significantly lower in the vaginal washing group (p\u2009&lt;\u20090.001).<\/jats:p><jats:p>\n            Conclusion\u2003Vaginal washing with normal saline before intravaginal prostaglandin insertion is a useful and easily applicable method for labor induction with good outcomes.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/s-0043-1763502","type":"journal-article","created":{"date-parts":[[2023,2,21]],"date-time":"2023-02-21T23:37:20Z","timestamp":1677022640000},"page":"988-997","source":"Crossref","is-referenced-by-count":0,"title":["Effect of Vaginal Washing before Intravaginal Prostaglandin Insertion on Induction of Labor: A Systematic Review and Meta-analysis of Randomized Controlled Trials"],"prefix":"10.1055","volume":"41","author":[{"given":"Saeed","family":"Baradwan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdulrahman","family":"Al-Matary","sequence":"additional","affiliation":[{"name":"Department of Neonatology, King Fahad Medical City, Riyadh, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Majed Saeed","family":"Alshahrani","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine, Najran University, Najran, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khalid","family":"Khadawardi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdullah","family":"Latifah","sequence":"additional","affiliation":[{"name":"College of Medicine, Alfaisal University, Riyadh, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed E.","family":"ElHodiby","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine, Misr University for Science and Technology, Giza, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammed","family":"Samy","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine, Ain Shams University, Cairo, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Safwat","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine, Ain Shams University, Cairo, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed","family":"Zaki","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed","family":"Hussein","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mahmoud A.","family":"Hegazy","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University, New Damietta, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suzan","family":"Elsharkawy","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine, Alexandria University, Alexandria, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9579-8366","authenticated-orcid":false,"given":"Ahmed Mohamed","family":"Abdelhakim","sequence":"additional","affiliation":[{"name":"Kasr Al-Ainy, Faculty of Medicine, Cairo University, Cairo, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rania Mahfouz","family":"Abdelwahed","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maii","family":"Nawara","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine, Ain Shams University, Cairo, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed A.","family":"Elsenity","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine, Ain Shams University, Cairo, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2023,2,21]]},"reference":[{"issue":"09","key":"ref1","doi-asserted-by":"crossref","first-page":"935","DOI":"10.1055\/s-0039-1701025","article-title":"Quantifying the risks and benefits of continuing labor induction: data for shared decision-making","volume":"38","author":"E N Teal","year":"2021","journal-title":"Am J Perinatol"},{"issue":"05","key":"ref2","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1055\/s-0040-1716711","article-title":"Labor induction at 39 weeks compared with expectant management in low-risk parous women","volume":"39","author":"S M Wagner","year":"2022","journal-title":"Am J Perinatol"},{"issue":"06","key":"ref3","doi-asserted-by":"crossref","first-page":"1357","DOI":"10.1097\/AOG.0000000000001778","article-title":"Mechanical and pharmacologic methods of labor induction: a randomized controlled trial","volume":"128","author":"L D Levine","year":"2016","journal-title":"Obstet Gynecol"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"e123","DOI":"10.1055\/s-0040-1708805","article-title":"Transcervical foley balloon plus vaginal misoprostol versus vaginal misoprostol alone for cervical ripening in nulliparous obese women: a multicenter, randomized, comparative-effectiveness trial","volume":"38","author":"O A Viteri","year":"2021","journal-title":"Am J Perinatol"},{"issue":"02","key":"ref5","doi-asserted-by":"crossref","first-page":"132","DOI":"10.3109\/14767058.2012.722729","article-title":"Labor induction with prostaglandin E2: characteristics of response and prediction of failure","volume":"26","author":"N Melamed","year":"2013","journal-title":"J Matern Fetal Neonatal Med"},{"issue":"06","key":"ref6","first-page":"CD003101","article-title":"Vaginal prostaglandin (PGE2 and PGF2a) for induction of labour at term","volume":"2014","author":"J Thomas","year":"2014","journal-title":"Cochrane Database Syst 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pH on release of PGE2 from vaginal and endocervical preparations for induction of labour","volume":"100","author":"I A MacDonald","year":"1993","journal-title":"Br J Obstet Gynaecol"},{"issue":"02","key":"ref25","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1016\/j.ijgo.2003.11.007","article-title":"Misoprostol wetting with acetic acid for pre-abortion cervical priming","volume":"85","author":"S Kelekci","year":"2004","journal-title":"Int J Gynaecol Obstet"},{"key":"ref26","first-page":"206","article-title":"The role of vaginal pH on efficacy of controlled-release dinoprostone vaginal insert for cervical ripening\/labor induction: a prospective double-blind study","volume":"9","author":"S \u00d6nen","year":"2008","journal-title":"J Turk Ger Gynecol Assoc"},{"issue":"01","key":"ref27","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1515\/jpm-2020-0212","article-title":"Comparative study regarding effect of pH on Misoprostol in induction of labor in full term 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