Document Detail


Randomized controlled trial of vaginal misoprostol versus dinoprostone vaginal insert for labor induction.
MedLine Citation:
PMID:  12854927     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To compare the safety and efficacy of vaginal misoprostol versus dinoprostone vaginal inserts for cervical ripening and labor induction. METHODS: Two hundred singleton gestations with an indication for cervical ripening and induction of labor were randomized to receive either 50 microg of misoprostol intravaginally every 3 h or a 10-mg dinoprostone vaginal insert every 12 h for a maximum of 24 h. Statistical analysis included Student's t test, the Mann-Whitney U test, chi2 analysis and Fisher's exact test. RESULTS: Ninety-seven women received vaginal misoprostol while 89 women received the dinoprostone vaginal insert. Fourteen women were removed from the study after randomization. The interval from start of induction to vaginal delivery (794.5 +/-408 min vs. 1005.3 +/- 523 min; p < 0.02) was significantly shorter in the misoprostol group. Women receiving misoprostol were more likely to deliver vaginally both in < 12 h (44% vs. 12%; p < 0.0001) and < 24 h (68% vs. 38%; p < 0.001). A non-reassuring fetal heart rate tracing was the indication for 71.4% (20/28) of Cesarean deliveries in the misoprostol group compared to 40% (14/35) in the dinoprostone group (p = 0.03). There were no significant differences in neonatal outcomes. CONCLUSION: Intravaginal misoprostol and dinoprostone are safe and effective medications for use in cervical ripening before labor induction. Misoprostol results in a shorter interval from induction to delivery. However, Cesarean delivery for a non-reassuring fetal heart rate tracing was more common with misoprostol.
Authors:
D Garry; R Figueroa; R B Kalish; C J Catalano; D Maulik
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians     Volume:  13     ISSN:  1476-7058     ISO Abbreviation:  J. Matern. Fetal. Neonatal. Med.     Publication Date:  2003 Apr 
Date Detail:
Created Date:  2003-07-11     Completed Date:  2003-07-25     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  101136916     Medline TA:  J Matern Fetal Neonatal Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  254-9     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, Winthrop University Hospital, Mineola, New York, USA.
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MeSH Terms
Descriptor/Qualifier:
Administration, Intravaginal
Adult
Apgar Score
Birth Weight
Delivery, Obstetric / methods
Dinoprostone / administration & dosage*
Female
Heart Rate, Fetal
Humans
Infant, Newborn
Intensive Care, Neonatal
Labor, Induced / methods*
Length of Stay
Misoprostol / administration & dosage*
Oxytocics / administration & dosage*
Pregnancy
Time Factors
Chemical
Reg. No./Substance:
0/Oxytocics; 363-24-6/Dinoprostone; 59122-46-2/Misoprostol

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


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