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Labor induction with prostaglandin E1 versus E2: a comparison of outcomes

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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Fig. 1: Flow diagram of study population.
Fig. 2: Distribution of indication for induction.
Fig. 3: Kaplan–Meier survival curve for ripening time interval to successful vaginal delivery among women with Bishop score of <6.

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Correspondence to Hector Mendez-Figueroa.

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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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