+ Site Statistics
References:
54,258,434
Abstracts:
29,560,870
PMIDs:
28,072,757
+ Search Articles
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ PDF Full Text
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Translate
+ Recently Requested

Comparative efficacy and safety of vaginal misoprostol versus dinoprostone vaginal insert in labor induction at term: a randomized trial



Comparative efficacy and safety of vaginal misoprostol versus dinoprostone vaginal insert in labor induction at term: a randomized trial



Archives of Gynecology and Obstetrics 280(1): 19-24



To compare efficacy and safety of vaginal misoprostol (PGE(1) analog) with dinoprostone (PGE(2) analog) vaginal insert for labor induction in term pregnancies. A total of 112 women with singleton pregnancies of > or =37 weeks of gestation, and low Bishop scores underwent labor induction. The subjects were randomized to receive either 50 mug misoprostol intravaginally every 4 h to a maximum of five doses or a 10 mg dinoprostone vaginal insert for a maximum of 12 h. Time interval from induction to vaginal delivery, vaginal delivery rates within 12 and 24 h, requirement of oxytocin augmentation, incidence of tachysystole and uterine hyperstimulation, mode of delivery, rate of cesarean section due to fetal distress and neonatal outcome were outcome measures. Student's t test, Chi square test, Fischer's exact test were used for statistical analysis. Time interval from induction to vaginal delivery was found to be significantly shorter in misoprostol group when compared to dinoprostone subjects (680 +/- 329 min vs. 1070 +/- 435 min, P < 0.001). Vaginal delivery rates within 12 h were found to be significantly higher with misoprostol induction [n = 37 (66%) vs. n = 25 (44.6%); P = 0.02], whereas vaginal delivery rates in 24 h did not differ significantly between groups [n = 41 (73.2%) vs. n = 36 (64.2%); P = 0.3]. More subjects required oxytocin augmentation in dinoprostone group [n = 35 (62.5%) vs. n = 20 (35.7%), P = 0.005] and cardiotocography tracings revealed early decelerations occurring more frequently with misoprostol induction (10.7 vs. 0%, P = 0.03). Tachysystole and uterine hyperstimulation, mode of delivery, rate of cesarean sections due to fetal distress and adverse neonatal outcome were not demonstrated to be significantly different between groups (P = 1, P = 0.5, P = 0.4, P = 0.22, P = 0.5). Using vaginal misoprostol is an effective way of labor induction in term pregnant women with unfavorable cervices, since it is associated with a shorter duration of labor induction and higher rates of vaginal delivery within 12 h. Misoprostol and dinoprostone are equally safe, since misoprostol did not result in a rise in maternal and neonatal morbidity, namely, tachysystole, uterine hyperstimulation, cesarean section rates and admission to neonatal intensive care units as reported previously in literature.

(PDF emailed within 0-6 h: $19.90)

Accession: 052212037

Download citation: RISBibTeXText

PMID: 19034471

DOI: 10.1007/s00404-008-0843-9


Related references

Randomized controlled trial of vaginal misoprostol versus dinoprostone vaginal insert for labor induction. Journal of Maternal-Fetal and Neonatal Medicine 13(4): 254-259, 2003

Low-dose vaginal misoprostol versus vaginal dinoprostone insert for induction of labor beyond 41st week: A randomized trial. Acta Obstetricia et Gynecologica Scandinavica 2019, 2019

Randomized trial of sustained-release vaginal dinoprostone with concurrent oxytocin versus vaginal misoprostol for induction of labor at term. American Journal of Obstetrics & Gynecology 187(6 Supplement): S175, 2002

A randomized trial of vaginal prostaglandin E(2) gel and dinoprostone vaginal insert for induction of labor at term. Primary Care Update for Ob/Gyns 5(4): 183, 2000

Labor induction with prostaglandin E1 misoprostol compared with dinoprostone vaginal insert: A randomized trial. Obstetrics and Gynecology 91(3): 401-405, 1998

Labor induction for premature rupture of membranes using vaginal misoprostol versus dinoprostone vaginal insert. American Journal of Perinatology 31(3): 181-186, 2014

Slow release vaginal insert of misoprostol versus orally administrated solution of misoprostol for induction of labor in primiparous term pregnant women: a randomized clinical trial. Bjog 2019, 2019

Misoprostol vaginal insert compared with dinoprostone vaginal insert: a randomized controlled trial. Obstetrics and Gynecology 112(4): 801-812, 2008

The efficacy of misoprostol vaginal insert compared with oral misoprostol in the induction of labor of nulliparous women: A randomized national multicenter trial. Acta Obstetricia et Gynecologica Scandinavica 2019, 2019

Randomized trial of concurrent oxytocin with a sustained-release dinoprostone vaginal insert for labor induction at term. American Journal of Obstetrics & Gynecology 186(1): 61-65, 2002

Efficacy and safety of six hourly vaginal misoprostol versus intracervical dinoprostone: a randomized controlled trial. Archives of Gynecology and Obstetrics 276(2): 119-124, 2007

Vaginally administered misoprostol versus the dinoprostone vaginal insert for preinduction cervical ripening and labor induction. American Journal of Obstetrics & Gynecology 176(1 PART 2): S113, 1997

Efficacy and safety of misoprostol vaginal insert vs. oral misoprostol for induction of labor. Journal of Perinatal Medicine 2018, 2018

Randomized study of vaginal misoprostol (PGE(1)) and dinoprostone gel (PGE(2)) for induction of labor at term. Ultrasound in Obstetrics and Gynecology 18(6): 629-635, 2002

Effect of extra-amniotic Foley's catheter and vaginal misoprostol versus vaginal misoprostol alone on cervical ripening and induction of labor in Kenya, a randomized controlled trial. Bmc Pregnancy and Childbirth 18(1): 300, 2018