open access

Vol 88, No 6 (2017)
Research paper
Published online: 2017-06-30
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Analysis of intravaginal misoprostol 0.2 mg versus intracervical dinoprostone 0.5 mg doses for labor induction at term pregnancies

Teresa Górnisiewicz1, Andrzej Jaworowski, Małgorzata Zembala-Szczerba1, Dorota Babczyk, Hubert Huras
DOI: 10.5603/GP.a2017.0060
·
Pubmed: 28727132
·
Ginekol Pol 2017;88(6):320-324.
Affiliations
  1. Clinical Department of Obstetrics and Perinatology, University Hospital, Cracow, Poland, Poland

open access

Vol 88, No 6 (2017)
ORIGINAL PAPERS Obstetrics
Published online: 2017-06-30

Abstract

Objectives: Labor-induction methods are used in about 23% of labors. Most commonly, pharmacological methods are used to pre-induct the labor with dinoprostone — a PGE2 analog, and misoprostol — a PGE1 analog. The aim of this study was to evaluate two pharmacological methods of labor induction with the use of prostaglandins applied via an intravagi­nal insert containing misoprostol at a dose of 0.2 mg and intracervical gel containing dinoprostone at a dose of 0.5 mg.

Material and methods: This retrospective study was conducted on a group of 50 adult patients qualified for the pre-induction of labor. Following data were recorded: the time from the drug administration to the beginning of regular contractile function, the time from administration to amniotic fluid rupture, the time from medicament administration to the vaginal labor or caesarean section, the duration of I, II and III stages of labor, the delivery method and in the event of caesarean section — the indications for surgery.

Results: In comparison to dinoprostone, the misoprostol application was found to shorten the time from drug administration to amniotic fluid rupture by 14.1 hours, the time to the beginning of the first stage of labor by 11.7 hours and from the drug administration to the delivery by 17.3 hours (p-value < 0.05). The duration of the first stage of labor in the misoprostol group was shorter by 1.2 hours than in dinoprostone group (p-value < 0.05).

Conclusions: Application of intravaginal insert with misoprostol at a dose of 0.2 mg appears to be a more effective method of labor induction in comparison to intracervical gel with dinoprostone at a dose of 0.5mg. Thorough analysis of these methods requires further studies.

Abstract

Objectives: Labor-induction methods are used in about 23% of labors. Most commonly, pharmacological methods are used to pre-induct the labor with dinoprostone — a PGE2 analog, and misoprostol — a PGE1 analog. The aim of this study was to evaluate two pharmacological methods of labor induction with the use of prostaglandins applied via an intravagi­nal insert containing misoprostol at a dose of 0.2 mg and intracervical gel containing dinoprostone at a dose of 0.5 mg.

Material and methods: This retrospective study was conducted on a group of 50 adult patients qualified for the pre-induction of labor. Following data were recorded: the time from the drug administration to the beginning of regular contractile function, the time from administration to amniotic fluid rupture, the time from medicament administration to the vaginal labor or caesarean section, the duration of I, II and III stages of labor, the delivery method and in the event of caesarean section — the indications for surgery.

Results: In comparison to dinoprostone, the misoprostol application was found to shorten the time from drug administration to amniotic fluid rupture by 14.1 hours, the time to the beginning of the first stage of labor by 11.7 hours and from the drug administration to the delivery by 17.3 hours (p-value < 0.05). The duration of the first stage of labor in the misoprostol group was shorter by 1.2 hours than in dinoprostone group (p-value < 0.05).

Conclusions: Application of intravaginal insert with misoprostol at a dose of 0.2 mg appears to be a more effective method of labor induction in comparison to intracervical gel with dinoprostone at a dose of 0.5mg. Thorough analysis of these methods requires further studies.

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Keywords

labor, induction, pregnancy, prostaglandins, misoprostol, dinoprostone

About this article
Title

Analysis of intravaginal misoprostol 0.2 mg versus intracervical dinoprostone 0.5 mg doses for labor induction at term pregnancies

Journal

Ginekologia Polska

Issue

Vol 88, No 6 (2017)

Article type

Research paper

Pages

320-324

Published online

2017-06-30

DOI

10.5603/GP.a2017.0060

Pubmed

28727132

Bibliographic record

Ginekol Pol 2017;88(6):320-324.

Keywords

labor
induction
pregnancy
prostaglandins
misoprostol
dinoprostone

Authors

Teresa Górnisiewicz
Andrzej Jaworowski
Małgorzata Zembala-Szczerba
Dorota Babczyk
Hubert Huras

References (17)
  1. Osterman MJ, Martin JA. Recent Declines in Induction of Labor by Gestational age. NCHS Data Brief No. 155. NHS Information Centre (NHS IC). NHS maternity statistics 2011-12 summary report. Leeds: Health and Social Care Information Centre, Hospital Episode Statistics. [www.hscic.gov.uk/catalogue/PUB09202/ nhs-mate-eng-2011-2012-rep.pdf]. Hyattsville, MD: National Centre for Health Statistics. ; 2014.
  2. Laughon SK, Zhang J, Grewal J, et al. Induction of labor in a contemporary obstetric cohort. Am J Obstet Gynecol. 2012; 206(6): 486.e1–486.e9.
  3. Gülmezoglu AM, Crowther CA, Middleton P, et al. Induction of labour for improving birth outcomes for women at or beyond term. Cochrane Database Syst Rev. 2006(4): CD004945.
  4. Gilstrop M, Sciscione A. Induction of labor--pharmacology methods. Semin Perinatol. 2015; 39(6): 463–465.
  5. Liu A, Lv J, Hu Y, et al. 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(4): 897–906.
  6. Yount SM, Lassiter N. The pharmacology of prostaglandins for induction of labor. J Midwifery Womens Health. 2013; 58(2): 133–144; quiz 238–239.
  7. Leduc D, Biringer A, Lee L, et al. Clinical Practice Obstetrics Committee, Special Contributors. Induction of labour. J Obstet Gynaecol Can. 2013; 35(9): 840–857.
  8. Wing DA, Miller H, Parker L, et al. Misoprostol Vaginal Insert Miso-Obs-204 Investigators. Misoprostol vaginal insert for successful labor induction: a randomized controlled trial. Obstet Gynecol. 2011; 117(3): 533–541.
  9. Sareen S, Chawla I, Singh P. Labor Induction with 50 μg Vaginal Misoprostol: Can We Reduce Induction-Delivery Intervals Safely? J Obstet Gynaecol India. 2014; 64(4): 270–273.
  10. Wing DA, Brown R, Plante LA, et al. Misoprostol vaginal insert and time to vaginal delivery: a randomized controlled trial. Obstet Gynecol. 2013; 122(2 Pt 1): 201–209.
  11. Chen W, Xue J, Peprah MK, 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(3): 346–354.
  12. Aghideh FK, Mullin PM, Ingles S, et al. A comparison of obstetrical outcomes with labor induction agents used at term. J Matern Fetal Neonatal Med. 2014; 27(6): 592–596.
  13. Facchinetti F, Fontanesi F, Del Giovane C. Pre-induction of labour: comparing dinoprostone vaginal insert to repeated prostaglandin administration: a systematic review and meta-analysis. J Matern Fetal Neonatal Med. 2012; 25(10): 1965–1969.
  14. Meyer M, Pflum J, Howard D. Outpatient misoprostol compared with dinoprostone gel for preinduction cervical ripening: a randomized controlled trial. Obstet Gynecol. 2005; 105(3): 466–472.
  15. Pevzner L, Alfirevic Z, Powers BL, et al. Cardiotocographic abnormalities associated with misoprostol and dinoprostone cervical ripening and labor induction. Eur J Obstet Gynecol Reprod Biol. 2011; 156(2): 144–148.
  16. Gibson KS, Waters TP. Measures of success: Prediction of successful labor induction. Semin Perinatol. 2015; 39(6): 475–482.
  17. Stephenson ML, Wing DA. Misoprostol for induction of labor. Semin Perinatol. 2015; 39(6): 459–462.

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