Document Detail


Is misoprostol safe for labor induction in twin gestations?
MedLine Citation:
PMID:  16492589     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To compare the safety and efficacy of intravaginal misoprostol to oxytocin for the induction of labor in twin gestations. METHODS: All twin gestations that underwent induction of labor with misoprostol or oxytocin during a 4-year period were identified from the Mount Sinai obstetrical database. Only twins > or = 34 weeks with a vertex presenting twin A were included. Labor and delivery characteristics, maternal complications and neonatal outcomes were compared between the two groups. RESULTS: Of 134 patients with twins, 57 initially received misoprostol and 77 received oxytocin. These groups had similar demographics, but women who received misoprostol had less cervical dilation (0.8 vs. 2.2 cm, p < 0.0001) and were less likely to be multiparous (19% vs. 44%, p = 0.003). There was a shorter length of induction to delivery (7.8 hours vs. 15.1 hours, p = 0.001) and a trend toward a lower cesarean section rate (16.9% vs. 31.6%, p = 0.06) in the oxytocin-only group. There were no cases of uterine rupture or maternal mortality in this series. There were no significant differences in neonatal outcomes between the two groups, but the sample size was underpowered to detect significant differences between the groups. CONCLUSIONS: Misoprostol and oxytocin both appear to be safe and efficacious for use in inductions of labor in twins in this limited retrospective investigation. The safety of these agents with regard to neonatal outcomes should be confirmed by larger studies.
Authors:
Melissa C Bush; Akos Csaba; Keith A Eddleman; Carl J Saphier
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Publication Detail:
Type:  Comparative Study; Journal Article    
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:  19     ISSN:  1476-7058     ISO Abbreviation:  J. Matern. Fetal. Neonatal. Med.     Publication Date:  2006 Jan 
Date Detail:
Created Date:  2006-02-22     Completed Date:  2006-08-02     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  101136916     Medline TA:  J Matern Fetal Neonatal Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  35-8     Citation Subset:  IM    
Affiliation:
Saddleback Memorial Medical Center, Laguna Hills, CA, 92653, USA. melissacbush@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Administration, Intravaginal
Adult
Cesarean Section / statistics & numerical data
Databases as Topic
Female
Humans
Labor Stage, First / drug effects
Labor, Induced / methods*
Misoprostol / therapeutic use*
Oxytocics / therapeutic use*
Oxytocin / therapeutic use
Parity
Pregnancy
Pregnancy, Multiple*
Retrospective Studies
Time Factors
Twins
Chemical
Reg. No./Substance:
0/Oxytocics; 50-56-6/Oxytocin; 59122-46-2/Misoprostol

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


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