Abstract
Objective
To compare the peripartum outcomes when labor is induced with prostaglandins E1 versus E2.
Methodology
The Consortium of Safe Labor database was utilized. Women with non-anomalous singletons >24 weeks gestation undergoing induction were analyzed. The primary endpoint was a composite adverse maternal outcome with a composite adverse neonatal outcome as our secondary outcome.
Results
Of the 228,438 births within the database, 8229 (10.8%) met inclusion criteria with 4703 (55.7%) receiving PGE1, and 3741 (44.3%), PGE2. The rate of vaginal delivery was similar between both. Composite adverse maternal outcome, was more likely among the prostaglandin E1: 7.2% vs. 1.5% (aOR 4.20; 95% CI 3.02–5.85); similar trend observed with composite adverse neonatal outcome rates: 4.6% vs. 1.4% (aOR 1.69; 95% CI 1.14–2.50).
Conclusion
Utilization of prostaglandin E1, compared to E2, was associated with an increased likelihood of adverse maternal and neonatal outcomes.
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References
Martin JA, Hamilton BE, Osterman MJK, Driscoll AK, Drake P. Births: final data for 2016. Natl Vital Stat Rep. 2018;67:1–55.
Ventura SJ, Martin JA, Curtin SC, Mathews TJ. Births: final data for 1997. Natl Vital Stat Rep. 1999;47:1–96.
Ayala NK, Rouse DJ. Nondefinitive studies of labor induction methods: enough already! Obstet Gynecol. 2019;134:7–9.
ACOG, Committee, on, Bulletins P, Obstetrics. ACOG practice bulletin no. 107: induction of labor. Obstet Gynecol. 2009;114:386–97.
National Collaborating Centre, for Women’s and Children’s Health. In: National Institute for Health, and Clinical Excellence, editors. Induction of Labour. 2nd ed. London: Royal College of Obstetricians and Gynaecologists; 2008. https://www.nice.org.uk/guidance/cg70/evidence/cg70-induction-of-labour-full-guideline2.
Sharp A, Faluyi D, Alfirevic Z. Misoprostol vaginal insert (Mysodelle) versus Dinoprostone intravaginal gel (Prostin) for induction of labour. Eur J Obstet Gynecol Reprod Biol. 2019;240:41–4.
Draycott T, van der Nelson H, Montouchet C, Ruff L, Andersson F. Reduction in resource use with the misoprostol vaginal insert vs the dinoprostone vaginal insert for labour induction: a model-based analysis from a United Kingdom healthcare perspective. BMC Health Serv Res. 2016;16:49.
Wing DA, Brown R, Plante LA, Miller H, Rugarn O, Powers BL. Misoprostol vaginal insert and time to vaginal delivery: a randomized controlled trial. Obstet Gynecol. 2013;122:201–9.
Austin SC, Sanchez-Ramos L, Adair 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.
Chen W, Xue J, Peprah MK, Wen SW, Walker M, Gao Y, et al. A systematic review and network meta-analysis comparing the use of Foley catheters, misoprostol, and dinoprostone for cervical ripening in the induction of labour. BJOG. 2016;123:346–54.
Wang L, Zheng J, Wang W, Fu J, Hou L. Efficacy and safety of misoprostol compared with the dinoprostone for labor induction at term: a meta-analysis. J Matern Fetal Neonatal Med. 2016;29:1297–307.
Liu A, Lv J, Hu Y, Lang J, Ma L, Chen W. Efficacy and safety of intravaginal misoprostol versus intracervical dinoprostone for labor induction at term: a systematic review and meta-analysis. J Obstet Gynaecol Res. 2014;40:897–906.
Rugarn O, Tipping D, Powers B, Wing DA. Induction of labour with retrievable prostaglandin vaginal inserts: outcomes following retrieval due to an intrapartum adverse event. BJOG. 2017;124:796–803.
Wing DA, Jones MM, Rahall A, Goodwin TM, Paul RH. A comparison of misoprostol and prostaglandin E2 gel for preinduction cervical ripening and labor induction. Am J Obstet Gynecol. 1995;172:1804–10.
Zhang J, Troendle J, Reddy UM, Laughon SK, Branch DW, Burkman R, et al. Contemporary cesarean delivery practice in the United States. Am J Obstet Gynecol. 2010;203:326.e1–10.
Zhang J, Landy HJ, Branch DW, Burkman R, Haberman S, Gregory KD, et al. Contemporary patterns of spontaneous labor with normal neonatal outcomes. Obstet Gynecol. 2010;116:1281–7.
Laughon SK, Zhang J, Troendle J, Sun L, Reddy UM. Using a simplified Bishop score to predict vaginal delivery. Obstet Gynecol. 2011;117:805–11.
von Elm E, Altman DG, Egger M, Pocock S, Gotzsche PC, Vandenbroucke JP. The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet. 2007;370:1453–7.
Young DC, Delaney T, Armson BA, Fanning C. Oral misoprostol, low dose vaginal misoprostol, and vaginal dinoprostone for labor induction: randomized controlled trial. PLoS ONE. 2020;15:e0227245.
De Bonrostro Torralba C, Tejero Cabrejas EL, Envid Lazaro BM, Franco Royo MJ, Roca Arquillue M, Campillos Maza JM. Low-dose vaginal misoprostol vs vaginal dinoprostone insert for induction of labor beyond 41st week: a randomized trial. Acta Obstet Gynecol Scand. 2019;98:913–9.
Mayer RB, Oppelt P, Shebl O, Pomer J, Allerstorfer C, Weiss C. Initial clinical experience with a misoprostol vaginal insert in comparison with a dinoprostone insert for inducing labor. Eur J Obstet Gynecol Reprod Biol. 2016;200:89–93.
Wang X, Yang A, Ma Q, Li X, Qin L, He T. Comparative study of titrated oral misoprostol solution and vaginal dinoprostone for labor induction at term pregnancy. Arch Gynecol Obstet. 2016;294:495–503.
Madaan M, Agrawal S, Puri M, Nigam A, Kaur H, Trivedi SS. Is low dose vaginal misoprostol better than dinoprostone gel for induction of labor: a randomized controlled trial. J Clin Diagn Res. 2014;8:OC31–4.
Gregson S, Waterstone M, Norman I, Murrells T. A randomised controlled trial comparing low dose vaginal misoprostol and dinoprostone vaginal gel for inducing labour at term. BJOG. 2005;112:438–44.
Rozenberg P, Chevret S, Senat MV, Bretelle F, Paule Bonnal A, Ville Y. A randomized trial that compared intravaginal misoprostol and dinoprostone vaginal insert in pregnancies at high risk of fetal distress. Am J Obstet Gynecol. 2004;191:247–53.
van Gemund N, Scherjon S, LeCessie S, van Leeuwen JH, van Roosmalen J, Kanhai HH. A randomised trial comparing low dose vaginal misoprostol and dinoprostone for labour induction. BJOG. 2004;111:42–9.
Dallenbach P, Boulvain M, Viardot C, Irion O. Oral misoprostol or vaginal dinoprostone for labor induction: a randomized controlled trial. Am J Obstet Gynecol. 2003;188:162–7.
Barrilleaux PS, Bofill JA, Terrone DA, Magann EF, May WL, Morrison JC. Cervical ripening and induction of labor with misoprostol, dinoprostone gel, and a Foley catheter: a randomized trial of 3 techniques. Am J Obstet Gynecol. 2002;186:1124–9.
Khoury AN, Zhou QP, Gorenberg DM, Nies BM, Manley GE, Mecklenburg FE. A comparison of intermittent vaginal administration of two different doses of misoprostol suppositories with continuous dinoprostone for cervical ripening and labor induction. J Matern Fetal Med. 2001;10:186–92.
Hofmeyr GJ, Alfirevic Z, Matonhodze B, Brocklehurst P, Campbell E, Nikodem VC. Titrated oral misoprostol solution for induction of labour: a multi-centre, randomised trial. BJOG. 2001;108:952–9.
Hughes EG, Kelly AJ, Kavanagh J. Dinoprostone vaginal insert for cervical ripening and labor induction: a meta-analysis. Obstet Gynecol. 2001;97:847–55.
Ozgur K, Kizilates A, Uner M, Erman O, Trak B. Induction of labor with intravaginal misoprostol versus intracervical dinoprostone. Arch Gynecol Obstet. 1997;261:9–13.
Wing DA, Ortiz-Omphroy G, Paul RH. A comparison of intermittent vaginal administration of misoprostol with continuous dinoprostone for cervical ripening and labor induction. Am J Obstet Gynecol. 1997;177:612–8.
Surbek DV, Boesiger H, Hoesli I, Pavic N, Holzgreve W. A double-blind comparison of the safety and efficacy of intravaginal misoprostol and prostaglandin E2 to induce labor. Am J Obstet Gynecol. 1997;177:1018–23.
Chuck FJ, Huffaker BJ. Labor induction with intravaginal misoprostol versus intracervical prostaglandin E2 gel (Prepidil gel): randomized comparison. Am J Obstet Gynecol. 1995;173:1137–42.
Veena B, Samal R, Inbaraj LR, George CE. Sublingual misoprostol (PGE1) versus intracervical dinoprostone (PGE2) gel for induction of labour: a randomized control trail. J Obstet Gynaecol India. 2016;66:122–8.
Hardardottir H, Baldursdottir R, Helgadottir LB. Misoprostol and dinoprostone for induction of labor: a prospective randomized study. Laeknabladid. 1999;85:961–7.
Sanchez-Ramos L, Peterson DE, Delke I, Gaudier FL, Kaunitz AM. Labor induction with prostaglandin E1 misoprostol compared with dinoprostone vaginal insert: a randomized trial. Obstet Gynecol. 1998;91:401–5.
Silfeler DB, Tandogan B, Ayvaci H, Silfeler I, Yenidede I, Dayicioglu V. A comparison of misoprostol, controlled-release dinoprostone vaginal insert and oxytocin for cervical ripening. Arch Gynecol Obstet. 2011;284:1331–7.
Rouzi AA, Alsibiani S, Mansouri N, Alsinani N, Darhouse K. Randomized clinical trial between hourly titrated oral misoprostol and vaginal dinoprostone for induction of labor. Am J Obstet Gynecol. 2014;210:56.e1–6.
Chitrakar NS. Comparison of Misoprostol versus Dinoprostone for pre-induction cervical ripening at-term. J Nepal Health Res Counc. 2012;10:10–5.
le Roux PA, Olarogun JO, Penny J, Anthony J. Oral and vaginal misoprostol compared with dinoprostone for induction of labor: a randomized controlled trial. Obstet Gynecol. 2002;99:201–5.
Hendrix NW, Chauhan SP, Scardo JA, Ellings JM, Devoe LD. Managing nonreassuring fetal heart rate patterns before cesarean delivery. Compliance with ACOG recommendations. J Reprod Med. 2000;45:995–9.
Hill AB. The environment and disease: association or causation? Proc R Soc Med. 1965;58:295–300.
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Mendez-Figueroa, H., Bicocca, M.J., Gupta, M. et al. Labor induction with prostaglandin E1 versus E2: a comparison of outcomes. J Perinatol 41, 726–735 (2021). https://doi.org/10.1038/s41372-020-00888-5
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DOI: https://doi.org/10.1038/s41372-020-00888-5