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Safety of misoprostol for near-term and term induction in small-for-gestational-age pregnancies compared to dinoprostone and primary cesarean section: results of a retrospective cohort study

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

Abstract

Objectives

Small-for-gestational-age (SGA) pregnancy is a condition often leading to labor induction due to concerns about the possibility of an increased risk for fetal morbidity and mortality. In this retrospective cohort study, we try to evaluate the safety of oral misoprostol for labor induction in near-term and term pregnancies in SGA fetuses compared to dinoprostone as well as to planned primary cesarean section.

Materials and methods

Retrospective analysis of labor indution and primary cesarean section in SGA pregnancies 37 weeks and beyond in a tertiary care centre. In total, 284 consecutive patients with SGA fetuses were included. 80 recieved oral misoprostol, 85 dinoprostone as vaginal Gel and 119 were delivered by means of primary cesarean section. Primary endpoints were umbilical aterial pH and APGAR 5′. Secondary endpoints were APGAR 1′ and 10′, rates of relevant acidosis with a pH < 7.11 and depressed children, NICU admissions and vaginal operative deliveries as well as cesarean sections after labor induction.

Results

No significant differences were found concerning the umbilical arterial pH. No significant differences were found concerning APGAR 5′ after labor induction; however, APGAR 5′ was significantly lower after primary cesarean section. Similar results were found concerning APGAR 1′, 10-min APGAR values were not significantly different. Rates of relevant acidosis and depressed children did not differ; no significant differences were found concerning NICU admissions between all groups and vaginal operative deliveries and CS rates after labor induciton.

Conclusion

Oral misoprosol is a safe method for labor induction in SGA near-term and term pregnancies and, concerning the neonatal outcome, comparable with other methods of labor induction or primary CS. Our study showed no adverse neonatal outcomes related to the use of oral misoprostol.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, University Medical Center (Universitätsmedizin) Mainz, Langenbeckstr. 1, 55131, Mainz, Germany

    Joscha Steetskamp, Elisabeth Bachmann, Annette Hasenburg & Marco Johannes Battista

Authors
  1. Joscha Steetskamp
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  2. Elisabeth Bachmann
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  3. Annette Hasenburg
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  4. Marco Johannes Battista
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Contributions

Joscha Steetskamp: data collection, statistics, and text editing/writing process. Elisabeth Bachmann: literature, data collection, and text editing. Parts of the results are used in Elisabeth Bachmann’s doctoral thesis. Annette Hasenburg: text editing, language correction, and literature. Marco Johannes Battista: language correction, writing process, and literature.

Corresponding author

Correspondence to Joscha Steetskamp.

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All authors declare no conflicts of interest.

Ethical approval

Study design, data collection and data processing were in accordance with institutional ethical and data protection standards for retrospective studies of the University Medical Centre Mainz as well as the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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All patients signed an agreement concerning anonymized data collection and processing for study purposes. In case of a missing agreement, the patient was not included.

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Steetskamp, J., Bachmann, E., Hasenburg, A. et al. Safety of misoprostol for near-term and term induction in small-for-gestational-age pregnancies compared to dinoprostone and primary cesarean section: results of a retrospective cohort study. Arch Gynecol Obstet 302, 1369–1374 (2020). https://doi.org/10.1007/s00404-020-05703-2

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  • DOI: https://doi.org/10.1007/s00404-020-05703-2

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