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Oral misoprostol versus vaginal dinoprostone for labor induction in nulliparous women at term

Journal of Perinatology volume 34, pages 95–99 (2014)Cite this article

Subjects

Abstract

Objective:

To compare the efficacy of oral misoprostol to vaginal dinoprostone for labor induction in nulliparous women.

Study design:

Admissions for labor induction from January 2008 to December 2010 were reviewed. Patients receiving oral misoprostol were compared with those receiving vaginal dinoprostone. The primary outcome was time from induction agent administration to vaginal delivery. Secondary outcomes included vaginal delivery within 24 h, mode of delivery and maternal and fetal outcomes.

Result:

A total of 680 women were included: 483 (71%) received vaginal dinoprostone and 197 (29%) received oral misoprostol. Women who received oral misoprostol had a shorter interval to vaginal delivery (27.2 vs 21.9 h, P<0.0001) and were more likely to deliver vaginally in <24 h (47% vs 64%, P=0.001). There was no increase in the rate of cesarean delivery or adverse maternal or neonatal outcomes.

Conclusion:

Labor induction with oral misoprostol resulted in shorter time to vaginal delivery without increased adverse outcomes in nulliparous women.

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References

  1. ACOG Practice Bulletin Number 107, August 2009. Induction of Labor.

  2. Spong CY, Berghella V, Wenstrom KD, Mercer BM, Saade GR . Preventing the first cesarean delivery. Obstet Gynecol 2012; 120 (5): 1181–1193.

    PubMed  PubMed Central  Google Scholar 

  3. Ehrenthal DB, Jiang X, Strobino DM . Labor induction and the risk of cesarean delivery among nulliparous women at term. Obstet Gynecol 2010; 116 (1): 35–42.

    Article  PubMed  Google Scholar 

  4. Heffner LJ, Elkin E, Fretts RC . Impact of labor induction, gestational age, and maternal age on cesarean delivery rates. Obstet Gynecol 2003; 102 (2): 287–293.

    PubMed  Google Scholar 

  5. Seyb ST, Berka RJ, Socol ML, Dooley SL . Risk of cesarean delivery in with elective induction of labor at term in nulliparous women. Obstet Gynecol 1999; 94 (4): 600–607.

    CAS  PubMed  Google Scholar 

  6. Austin SC, Sanchez-Ramos L, Adiar CD . Labor induction with intravaginal misoprostol compared with the dinoprostone vaginal insert: a systematic review and metaanalysis. Am J Obstet Gynecol 2010; 202: 624.e1–9.

    Article  CAS  Google Scholar 

  7. Hofmeyr GJ, Gulmezoglu AM, Pileggi C . Vaginal misoprostol for cervical ripening and induction of labour. Cochrane Database Syst Rev 2010;; ((10): CD000941.

  8. Megalo A, Megalo A, Petignat P, Hohlfeld P . Influence of misoprostol or prostaglandin E2 for induction of labor on incidence of pathologic CTG tracing: a randomized tiral. E J Obstet Gynecol Reprod Bio 2004; 116 (1): 34–38.

    Article  CAS  Google Scholar 

  9. Ozkan S, Ozkan S, Calişkan E, Doğer E, Yücesoy I, Ozeren S et al. Comparative efficacy and safety of vaginal misoprostol versus dinoprostone vaginal insert in labor induction at term: a randomized trial. Arch Gynecol Obstet 2009; 280 (1): 19–24.

    Article  PubMed  Google Scholar 

  10. Ramsey PS, Ramsey PS, Harris DY, Ogburn PL Jr, Heise RH, Magtibay PM et al. Comparative efficacy and cost of the prostaglandin analogs dinoprostone and misoprostol as labor preinduction agents. Am J Obstet Gynecol 2003; 188: 560–565.

    Article  CAS  PubMed  Google Scholar 

  11. Sanchez-Ramos L, Kaunitz AM . Misoprostol for cervical ripening and labor induction: a systematic review of the literature. Clin Obstet Gynecol 2000; 43 (3): 475–488.

    Article  CAS  PubMed  Google Scholar 

  12. Weeks A, Alfirevic Z, Faúndes A, Hofmeyr GJ, Safar P, Wing Ds . Misoprostol for induction of labor with a live fetus. Int J Gynecol Obstet 2007; 99: S194–S197.

    Article  CAS  Google Scholar 

  13. Alfirevic Z, Weeks A . Oral misoprostol for induction of labour. Cochrane Database Syst Rev 2006; (2): CD001338.

  14. Colon I, Clawson K, Hunter K, Druzin ML, Taslimi MM . Prospective randomized clinical trial of inpatient cervical ripening with stepwise oral misoprostol versus vaginal misoprostol. Am J Obstet Gynecol 2005; 192: 747–752.

    Article  CAS  PubMed  Google Scholar 

  15. American College of Obstetricians and Gynecologists. ACOG Practice Bulletin Number 106, July 2009. Intrapartum Fetal Heart Rate Monitoring: Nomenclature, Interpretation, and General Management Principles 2009; 114 (1): 192–202.

  16. Wing DA, Park MR, Paul RH . A randomized comparison of oral and intravaginal misoprostol for labor induction. Obstet Gynecol 2000; 95: 905–908.

    CAS  PubMed  Google Scholar 

  17. Dällenbach P, Boulvain M, Viardot C, Irion Os . Oral misoprostol or vaginal dinoprostone for labor induction: A randomized controlled trial. Am J Obset Gynecol 2003; 188: 162–167.

    Article  Google Scholar 

  18. Dodd J, Crowther CA, Robinson JS . Oral misoprostol for induction of labour at term: a randomized controlled trial. BMJ 2006; 332 (7540): 509–513.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Hofmeyr GJ, Alfirevic Z, Matonhodze B, Brocklehurst P, Campbell E, Nikodem VC . Titrated oral misoprostol for induction of labour: a multi-centre, randomised trial. Br J Obstet Gynaecol 2001; 108 (9): 952–959.

    CAS  Google Scholar 

  20. Langenegger EJ, Odendaal HJ, Grove D . Oral misoprostol versus intracervical dinoprostone for induction of labor. Int J Gynecol Obstet 2005; 88: 242–248.

    Article  CAS  Google Scholar 

  21. le Roux PA, Olarogun JO, Penny J, Anthony Js . Oral and vaginal misoprostol compared with dinoprostone for induction of labor: a randomized controlled trial. Obstet Gynecol 2002; 99: 201–205.

    CAS  PubMed  Google Scholar 

  22. Shetty A, Livingstone I, Acharya S, Rice P, Danielian P, Templeton A . A randomized comparison of oral misoprostol and vaginal prostaglandin E2 tablets in labour induction at term. Br J Obstet Gynaecol 2004; 111: 436–440.

    Article  CAS  Google Scholar 

  23. Kundodyiwa TW, Afrevic Z, Weeks AD . Low-dose oral misoprostol for induction of labor: a systematic review. Obstet Gynecol 2009; 113: 374–383.

    Article  CAS  PubMed  Google Scholar 

  24. Mozurkewich EL, Chilimigras JL, Berman DR, Perni UC, Romero VC, King VJ et al. Methods of induction of labour: a systematic review. BMC Pregnancy Childbirth 2011; 11: 84.

    Article  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. Department of Obstetrics & Gynecology, Stanford University, CA, Stanford, USA

    A M Faucett, K Daniels, Y Y EL-Sayed & Y J Blumenfeld

  2. Department of Pediatrics, Stanford University, CA, Stanford, USA

    H C Lee

Authors
  1. A M Faucett
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  2. K Daniels
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  3. H C Lee
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  4. Y Y EL-Sayed
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  5. Y J Blumenfeld
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Correspondence to A M Faucett.

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Faucett, A., Daniels, K., Lee, H. et al. Oral misoprostol versus vaginal dinoprostone for labor induction in nulliparous women at term. J Perinatol 34, 95–99 (2014). https://doi.org/10.1038/jp.2013.133

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