Document Detail


Effectiveness of prostaglandin E2 intracervical gel (Prepidil), with immediate oxytocin, versus vaginal insert (Cervidil) for induction of labor.
MedLine Citation:
PMID:  9822496     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Our purpose was to compare the effectiveness of labor induction with use of prostaglandin E2 either as an intracervical gel (Prepidil), with immediate oxytocin, or as a sustained-release vaginal insert (Cervidil) with subsequent oxytocin as needed. STUDY DESIGN: Hospitalized patients at >/=37 weeks' gestation requiring labor induction and having an unfavorable cervix (Bishop score </=6) were randomly assigned to receive either Prepidil or Cervidil. Oxytocin was begun immediately after Prepidil placement or 30 minutes after removal of the Cervidil insert if needed. RESULTS: Of the 150 patients, there were no differences in demographics and eventual pregnancy outcomes between the Prepidil group (n = 77) and the Cervidil group (n = 73). Those pregnancies receiving the Prepidil-immediate oxytocin regimen were delivered sooner than those receiving the Cervidil among nulliparous (11.3 +/- 7.3 hours vs 25.2 +/- 12.5 hours, P <.001) and multiparous (8.4 +/- 7.8 hours vs 18.4 +/- 7.2 hours, P <.001) women. The mean cost savings, which favored the Prepidil-immediate oxytocin regimen, was $458 (range $204 to $630) per patient. CONCLUSION: Compared with Cervidil, the Prepidil-immediate oxytocin regimen resulted in a shorter induction-to-vaginal delivery interval and in more hospital cost savings without increasing adverse outcomes.
Authors:
J D Stewart; W F Rayburn; K C Farmer; E M Liles; A H Schipul; J R Stanley
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  179     ISSN:  0002-9378     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  1998 Nov 
Date Detail:
Created Date:  1998-12-23     Completed Date:  1998-12-23     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1175-80     Citation Subset:  AIM; IM    
Affiliation:
Section of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.
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MeSH Terms
Descriptor/Qualifier:
Administration, Intravaginal
Adult
Cervix Uteri
Cost-Benefit Analysis
Dinoprostone / administration & dosage*,  therapeutic use
Drug Therapy, Combination
Female
Gels
Humans
Labor, Induced / economics,  methods*
Oxytocin / therapeutic use*
Parity / physiology
Pregnancy
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Gels; 363-24-6/Dinoprostone; 50-56-6/Oxytocin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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