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Efficacy and safety of misoprostol, dinoprostone and Cook’s balloon for labour induction in women with foetal growth restriction at term

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Background and objectives

To compare effectiveness and safety of dinoprostone, misoprostol and Cook’s balloon as labour-inducing agents in women with intrauterine growth restriction (IUGR) at term.

Methods

Retrospective cohort chart review of women diagnosed with foetal growth restriction at term in Reina Sofia Hospital, Cordoba, Spain from January 2014 to December 2015. Registration of baseline characteristics and method of induction was made. The main outcome was time from induction to delivery. Obstetric and perinatal outcomes were also collected.

Results

A total of 99 women were diagnosed with IUGR in the mentioned period. Of them, 21 women were induced with dinoprostone [dinoprostone group (DG)], 20 with misoprostol (MG) and in 58 with Cook’s balloon (CG). Groups were homogeneous regarding pre-induction Bishop score and parity. The CG required more time (24.36 vs. 19.23 h; p = 0.02) and more oxytocin dose for conduction of labour from induction to delivery (6.75 vs. 1.24 mUI; p < 0.01) than DG. Moreover, the CG also needed more oxytocin than MG, 6.75 vs. 2.37 mUI (p < 0.001). Caesarean rate was 5, 14.9 and 17.3% in MG, DG and CG, respectively. No differences were observed in rates of uterine tachysystole, non-reassuring foetal status and neonatal adverse events.

Interpretation and conclusions

Prostaglandins were more effective than Cook’s balloon to induce labour and achieve vaginal birth in this sample of women with IUGR at term, with a similar safety profile.

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Authors and Affiliations

  1. Hospital Universitario Reina Sofía, Córdoba, Spain

    Jorge Duro-Gómez, Ana Belén Rodríguez-Marín, Antonio Jesús de la Torre González & José Eduardo Arjona-Berral

  2. Clínica Universidad de los Andes, Santiago de Chile, Chile

    María Fernanda Garrido-Oyarzún

  3. Clinic Institute of Gynecology, Obstetrics and Neonatology, Hospital Clinic-Institut d’Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain

    Camil Castelo-Branco

  4. Department of Gynecology and Obstetrics, Hospital Clinic I Provincial de Barcelona, c/Villarroel 170, 08036, Barcelona, Spain

    Camil Castelo-Branco

Authors
  1. Jorge Duro-Gómez
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  2. María Fernanda Garrido-Oyarzún
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  3. Ana Belén Rodríguez-Marín
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  4. Antonio Jesús de la Torre González
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  5. José Eduardo Arjona-Berral
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  6. Camil Castelo-Branco
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Contributions

JDG: project development, data collection and analysis, and manuscript writing. MFGO: data analysis and manuscript editing. ABRM: data collection and management. AJTG: data collection and management. JEAB: data management and analysis, and manuscript editing. CC-B: data analysis, manuscript writing and editing

Corresponding author

Correspondence to Camil Castelo-Branco.

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Conflict of interest

We, the authors, declare that we have no conflict of interest.

Informed consent

This survey was conducted as an open prospective quasi-experimental cohort study and was approved by the institutional review board of the Reina Sofia Hospital (Córdoba, Spain. Reference 246-26/11/2015). All of the procedures were in accordance with the Helsinki Declaration of 1975.

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Duro-Gómez, J., Garrido-Oyarzún, M.F., Rodríguez-Marín, A.B. et al. Efficacy and safety of misoprostol, dinoprostone and Cook’s balloon for labour induction in women with foetal growth restriction at term. Arch Gynecol Obstet 296, 777–781 (2017). https://doi.org/10.1007/s00404-017-4492-8

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  • DOI: https://doi.org/10.1007/s00404-017-4492-8

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