Obesity and cervical ripening failure risk.

OBJECTIVE: To estimate the impact of obesity on cervical ripening with prostaglandin E2 (PGE2). MATERIALS AND METHOD: A retrospective study compared the cervical ripening efficiency of PGE2 on patients with BMI above 30 kg/m(2) and normal weight patients with BMI between 20 kg/m(2) and 25 kg/m(2). In case of a Bishop score (≤3), a dinoprostone tampon was used over 12 h. In case of a Bishop score (4;6), a dinoprostone gel was used over 6 h. Failure of first cervical ripening attempt was defined, as the persistence of a Bishop score <6, 12 h after dinoprostone tampon or 6 h after dinoprostone gel. RESULTS: Ninety-five obese patients were matched according to parity to 190 non-obese patients. The failure rate of the first attempt at cervical ripening was significantly higher (P = 0.0016) among obese patients (53.7%) as compared to patients with a BMI in between 20 and 25 (34.2%). After multivariate analysis BMI ≥ 30 (OR = 2.32 (1.47-4.00), P = 0.0019), parity ≤2 (OR = 2.50 (1.20-5.26) P = 0.0137), and the Bishop score ≤3 (OR = 2.62 (1.45-4.72), P = 0.0014) were significantly and independently associated to prostaglandin ripening failure. CONCLUSION: Obesity seems to be associated to lower E2 prostaglandin sensitivity.