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Comparison of Misoprostol versus Dinoprostone for pre-induction cervical ripening at-term.
MedLine Citation:
PMID:  22929629     Owner:  NLM     Status:  In-Data-Review    
Background: The purpose of this study was to compare the efficacy and safety of 25μg Misoprostol vs. 0.5mg Dinoprostone for pre-labour ripening of the cervix at-term. Methods: Nullipara or Para one women with unfavourable cervices after 37 completed weeks with live foetuses were randomized to received either 25μg intravaginal Misoprostol or 0.5mg intracervical Dinoprostone. The doses were repeated after 6 hrs if the Bishop Score was less than 6. In cases, in which cervical ripening was not reached even after two doses of ripening agents, oxytocin induction was started at least 6 hours apart. Insertion delivery interval (IDI), complications and pregnancy outcome associated with the use of drugs were compared. Results: Two hundred women - 100 in each group were evaluated. Comparatively more women (62% vs. 58%) in the Misoprostol group achieved cervical ripening (BS≥6) after one dose. The mean IDI was significantly shorter (3.91 hrs) in the Misoprostol group. The difference was marked more among the multipara at 5.72 hrs, mean difference (p=0.045). In the Misoprostol group 76.92% delivered within 24 hrs whereas, only 70.4% in the Dinoprostone group. Vaginal deliveries were achieved more in the Misoprostol group (78% vs. 71%). No significant differences found in terms of intrapartum complications and foetal outcome. Meconium stained liquor was found more in the Dinoprostone group (23% vs. 32%). Conclusions: A 25μg dose of Misoprostol is superior in promoting cervical ripening, significantly shortened the insertion delivery interval. It is safe and effective for cervical ripening when applied in the hospital setting with close monitoring. Keywords: dinoprostone, induction, labour, misoprostol.
N S Chitrakar
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of Nepal Health Research Council     Volume:  10     ISSN:  1999-6217     ISO Abbreviation:  J Nepal Health Res Counc     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-08-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101292936     Medline TA:  J Nepal Health Res Counc     Country:  Nepal    
Other Details:
Languages:  eng     Pagination:  10-5     Citation Subset:  IM    
Paropakar Maternity and Women's Hospital, Kathmandu, Nepal.
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