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Abstract

Background: Gestational diabetes mellitus (GDM) is a rising concern in obstetric care due to its association with adverse maternal and fetal outcomes. Timely and effective labor induction strategies are critical to optimize delivery outcomes in these patients. Prostaglandin E2 (PGE2) is commonly employed for cervical ripening, yet its success in women with GDM remains variably reported. Identifying clinical predictors of successful vaginal delivery following induction can help guide patient management.
Objective: To determine the frequency of successful vaginal delivery in women with GDM induced with Prostaglandin E2 at term and to assess the influence of maternal characteristics on delivery outcomes.
Methods: This cross-sectional study was conducted at the Department of Obstetrics and Gynecology, CMH Kohat, from December 3, 2023, to June 2, 2024. A total of 135 women aged 18–40 years with singleton pregnancies beyond 36 weeks gestation and diagnosed with GDM were enrolled through non-probability consecutive sampling. Induction of labor was performed using 2 mg vaginal PGE2 gel every 12 hours, up to a maximum of three doses. Successful vaginal delivery (SVD) was defined as delivery within 24 hours of induction without surgical intervention. Data were analyzed using SPSS version 26.
Results: The mean age and BMI of participants were 30.44 ± 5.54 years and 23.91 ± 2.51 kg/m², respectively. Of the 135 women, 103 (76.3%) achieved successful vaginal delivery. Significant associations were found between SVD and BMI (p = 0.001), as well as GDM duration (p = 0.007). No significant association was observed with maternal age, parity, or gestational age.
Conclusion: Prostaglandin E2 is an effective agent for inducing labor in women with GDM. Lower BMI and shorter GDM duration appear to favor successful vaginal delivery.