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Labor Induction with 50 μg Vaginal Misoprostol: Can We Reduce Induction-Delivery Intervals Safely?

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Abstract

Objective

To compare the efficacy and safety profile of two methods of labor induction i.e., intracervical dinoprostone gel (0.5 mg 8 h) and misoprostol (50 μg 4 h) for induction of labor in women with a poor Bishop’s score.

Design

Observational study.

Study Period

January 1st, 2009 to December 31st, 2010.

Population

A total of 329 women with unfavorable cervices induced at or near term.

Methods

Two cervical ripening agent study arms were used: dinoprostone gel (193 women) and misoprostol (137 women).

Main Outcome Measures

Induction to delivery interval, cesarean section, incidence of meconium stained liquor, FHR pattern, incidence of uterine hyperstimulation, and neonatal outcomes.

Results

The induction to delivery interval was significantly shorter in the misoprostol group as compared to the dinoprostone group (p < 0.001). There was no difference in cesarean section rates between the two groups (dinoprostone gel 43 %; misoprostol 33 %; p = 0.144). The incidence of non-reassuring fetal heart rate pattern, meconium stained liquor, and uterine hyperstimulation were equivalent in both the groups (p = 0.529; 0.733; and 0.321, respectively). The neonatal outcomes in both the groups were comparable in terms of Apgar scores at birth (p = 0.160) and NICU admissions (p = 0.951).

Conclusions

Labor induction in women with unfavorable cervices results in high caesarean section rates. However, the use of misoprostol significantly reduces the induction to delivery interval, without adversely affecting the caesarean section rates and neonatal outcomes. Hence it may become a cost-effective alternative to dinoprostone gel in resource-poor settings like India.

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References

  1. ACOG (1999) Induction of labour. ACOG practice bulletin number 10. Washington, DC, USA: The American College of Obstetricians and Gynecologists.

  2. Wing DA, Jones MM, Rahall A, et al. A comparison of misoprostol and prostaglandin E2 gel for preinduction cervical ripening and labor induction. Am J Obstet Gynecol. 1995;172:1804–10.

    Article  CAS  PubMed  Google Scholar 

  3. Wing DA, Rahall A, Jones MM, et al. Misoprostol: an effective agent for cervical ripening and labor induction. Am J Obstet Gynecol. 1995;172:1811–6.

    Article  CAS  PubMed  Google Scholar 

  4. Chuck FJ, Huffaker BJ. Labor induction with intravaginal misoprostol versus intracervical prostaglandin E2 gel (prepidil gel): randomized comparison. Am J Obstet Gynecol. 1995;173:1137–42.

    Article  CAS  PubMed  Google Scholar 

  5. Varaklis K, Gumina R, Stubblefield PG. Randomized controlled trial of vaginal misoprostol and intracervical prostaglandin E2 gel for induction of labor at term. Obstet Gynecol. 1995;86:541–4.

    CAS  PubMed  Google Scholar 

  6. Mundle WR, Young DC. Vaginal misoprostol for induction of labor: a randomized controlled trial. Obstet Gynecol. 1996;88:521–5.

    Article  CAS  PubMed  Google Scholar 

  7. Gottschall DS, Borgida AF, Mihalek JJ, et al. A randomised clinical trial comparing misoprostol with prostaglandin E2 gel for preinduction cervical ripening. Am J Obstet Gynecol. 1997;177:1067–70.

    Article  CAS  PubMed  Google Scholar 

  8. Buser D, Mora G, Arias F. A randomised comparison between misoprostol and dinoprostone for cervical ripening and labor induction in patients with unfavorable cervices. Obstet Gynecol. 1997;89:581–5.

    Article  CAS  PubMed  Google Scholar 

  9. Sanchez-Ramos L, Peterson DE, Delke I, et al. Induction with prostaglandin E1 misoprostol compared with dinoprostone vaginal insert: a randomised trial. Obstet Gynecol. 1998;91:401–5.

    Article  CAS  PubMed  Google Scholar 

  10. Kolderup L, McLean L, Grullon K, et al. Misoprostol is more efficacious for labor induction than prostaglandin E2, but is it associated with more risk? Am J Obstet Gynecol. 1999;180:1543–5150.

    Article  CAS  PubMed  Google Scholar 

  11. Danielian P, Porter B, Ferri N, et al. Misoprostol for induction of labor at term: a more effective agent than dinoprostone vaginal gel. Br J Obstet Gynaecol. 1999;106:793–7.

    Article  CAS  PubMed  Google Scholar 

  12. Nunes F, Rodrigues R, Meirinho M. Randomized comparison between intravaginal misoprostol and dinoprostone for cervical ripening and induction of labor. Am J Obstet Gynecol. 1999;181:626–9.

    Article  CAS  PubMed  Google Scholar 

  13. Fletcher H, Mitchell S, Frederick J, et al. Intravaginal misoprostol versus dinoprostone as cervical ripening and labor-inducing agents. Obstet Gynecol. 1994;83:244–7.

    CAS  PubMed  Google Scholar 

  14. Surbek DV, Boesiger H, Hoesli I, et al. A double-blind comparison of the safety and efficacy of intravaginal misoprostol and prostaglandin E2 to induce labor. Am J Obstet Gynecol. 1997;177:1018–23.

    Article  CAS  PubMed  Google Scholar 

  15. Wing DA, Ortiz-Omphroy G, Paul RH. A comparison of intermittent vaginal administration of misoprostol with continuous dinoprostone for cervical ripening and labor induction. Am J Obstet Gynecol. 1997;177:612–8.

    Article  CAS  PubMed  Google Scholar 

  16. Sanchez-Ramos L, Kaunitz AM, Wears RL, et al. Misoprostol for cervical ripening and labor induction: a metaanalysis. Obstet Gynecol. 1997;89:633–42.

    Article  CAS  PubMed  Google Scholar 

  17. American College of Obstetricians and Gynecologists (1999) Induction of labor with misoprostol. ACOG committee opinion no. 228. Washington, DC 7: American College of Obstetricians and Gynecologists.

  18. Sanchez-Ramos L. Induction of labor. Obstet Gynecol Clin N Am. 2005;32:181–200.

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Obstetrics & Gynecology, Dr. RML Hospital & PGIMER, New Delhi, 110001, India

    Sweta Sareen (Senior Resident), Indu Chawla (Associate Professor) & Pushpa Singh (Professor & Head of Department)

  2. 3/18, 2nd Floor, Old Rajender Nagar, New Delhi, 110060, India

    Sweta Sareen (Senior Resident)

Authors
  1. Sweta Sareen
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  2. Indu Chawla
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  3. Pushpa Singh
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Correspondence to Sweta Sareen.

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Sareen, S., Chawla, I. & Singh, P. Labor Induction with 50 μg Vaginal Misoprostol: Can We Reduce Induction-Delivery Intervals Safely?. J Obstet Gynecol India 64, 270–273 (2014). https://doi.org/10.1007/s13224-014-0521-8

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  • DOI: https://doi.org/10.1007/s13224-014-0521-8

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